Provider Demographics
NPI:1316105042
Name:GATE WAY HEALTH CARE ASSOCIATES LLC
Entity type:Organization
Organization Name:GATE WAY HEALTH CARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EALISE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:910-536-5749
Mailing Address - Street 1:201 MARTIN LUTHER KING DR
Mailing Address - Street 2:PO BOX 1463
Mailing Address - City:BLADENBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28320
Mailing Address - Country:US
Mailing Address - Phone:910-536-5749
Mailing Address - Fax:
Practice Address - Street 1:201 MARTIN LUTHER KING DR
Practice Address - Street 2:
Practice Address - City:BLADENBORO
Practice Address - State:NC
Practice Address - Zip Code:28320
Practice Address - Country:US
Practice Address - Phone:910-536-5749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management