# GATEWAY BEHAVIORAL HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598367880
- **Authorized official:** GRACE DOH PMHNP (PRESIDENT)
- **Authorized official phone:** (240) 505-5427

## Contact information

- **Practice address:** 6500 MANTON WAY, LANHAM, MD 20706-2487
- **Practice address phone:** (240) 505-5427
- **Mailing address:** 6500 MANTON WAY, LANHAM, MD 20706-2487
- **Mailing address phone:** (240) 505-5427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/11/2020
- **Last updated:** 01/26/2021