Provider Demographics
NPI:1902079593
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
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 1:612 E DR MARTIN LUTHER KING JR DR
Mailing Address - Street 2:
Mailing Address - City:MAXTON
Mailing Address - State:NC
Mailing Address - Zip Code:28364-1800
Mailing Address - Country:US
Mailing Address - Phone:910-536-5749
Mailing Address - Fax:910-844-2964
Practice Address - Street 1:612 E DR MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:MAXTON
Practice Address - State:NC
Practice Address - Zip Code:28364-1800
Practice Address - Country:US
Practice Address - Phone:910-536-5749
Practice Address - Fax:910-844-2964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services