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Organization
GATEWAY ACADEMY, LLC
Active
Organization
GATEWAY ACADEMY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE EVANS (BO)
(801) 766-6604
Entity
Organization
Contact information
Practice address
941 E CATTAIL DR, DRAPER, UT 84020-8583
(801) 523-3479
(801) 437-2984
Mailing address
941 E CATTAIL DR, DRAPER, UT 84020-8583
(801) 523-3479
(801) 437-2984
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
14178
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95860
UT LICENSE
UT
Enumeration date
09/04/2015
Last updated
11/02/2022
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