# GATEWAY RESIDENTIAL PROGRAMS

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

## Provider details

- **NPI number:** 1609412063
- **Authorized official:** JEFF BEESLEY LMFT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (916) 782-1111

## Contact information

- **Practice address:** 1780 VERNON ST STE 1, ROSEVILLE, CA 95678-6311
- **Practice address phone:** (916) 782-1111
- **Practice address fax:** (916) 782-4544
- **Mailing address:** 1780 VERNON ST STE 1, ROSEVILLE, CA 95678-6311
- **Mailing address phone:** (916) 782-1111
- **Mailing address fax:** (916) 782-4544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | — | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 11/20/2019
- **Last updated:** 09/07/2022