Organization
GATEWAY TO SUCCESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DETRA JETT (CHIEF EXECUTIVE OFFICER)
(513) 225-9609
Entity
Organization
Contact information
Practice address
3493 CRAIG AVE, CINCINNATI, OH 45211-5727
(513) 225-9609
(513) 813-3032
Mailing address
3493 CRAIG AVE, CINCINNATI, OH 45211-5727
(513) 225-9609
(513) 813-3032
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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