Organization
GATEWAY BEHAVIORAL HEALTH SERVICES
Active
Other names
Gateway BHS - Glynn TC Now
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM PARKS CPA, CFO (CHIEF FINANCIAL OFFICER)
(912) 554-8464
Entity
Organization
Contact information
Practice address
2809 4TH STREET, BRUNSWICK, GA 31520
(912) 264-1674
(912) 262-9836
Mailing address
700 COASTAL VILLAGE DR, SUITE 102, BRUNSWICK, GA 31520-1974
(912) 554-8510
(912) 264-5965
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000625424A
—
GA
Enumeration date
03/13/2007
Last updated
10/18/2011
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