# CRESTVIEW HOSPITAL COMPANY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CRESTVIEW HOSPITAL COMPANY, LLC
- **Other names:** Gateway Medical Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1659348712
- **Legal business name:** CRESTVIEW HOSPITAL COMPANY, LLC
- **Authorized official:** PAULA LALOR (SR. DIRECTOR)
- **Authorized official phone:** (629) 215-3953

## Contact information

- **Practice address:** 127 E REDSTONE AVE, STE C, CRESTVIEW, FL 32539-5358
- **Practice address phone:** (850) 423-0061
- **Mailing address:** PO BOX 198002, ATLANTA, GA 30384-8002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | HCC3810 | FL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/07/2006
- **Last updated:** 03/22/2023