Organization
GATEWAY RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN GRAVES (MANAGEMENT AGENT)
(970) 823-0033
Entity
Organization
Contact information
Practice address
3338 ASH MESA RD, DELTA, CO 81416-8766
(970) 823-0033
Mailing address
3346 ASH MESA RD, DELTA, CO 81416-8766
(970) 823-0033
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/14/2021
Last updated
11/24/2021
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