Organization
GATEWAY COMMUNITY CHARTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON SAMPLE (SUPERINTENDENT/CEO)
(916) 286-5129
Entity
Organization
Contact information
Practice address
5112 ARNOLD AVE STE A, MCCLELLAN, CA 95652-1075
(916) 286-5129
Mailing address
5112 ARNOLD AVE STE A, MCCLELLAN, CA 95652-1075
(916) 286-5129
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/19/2025
Last updated
03/20/2025
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