Organization
GATEWAY BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM PARKS CFO (CHIEF FINANCIAL OFFICER)
(912) 554-8464
Entity
Organization
Contact information
Practice address
700 CHARLES GILMAN JR AVE, KINGSLAND, GA 31548-6292
(912) 729-4203
(912) 729-6977
Mailing address
700 COASTAL VILLAGE DR, BRUNSWICK, GA 31520-1974
(912) 554-8510
(912) 264-5965
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606339F
—
GA
Enumeration date
03/05/2007
Last updated
10/20/2011
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