Organization
GATEWAY HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN GAUDIOSO LICSW (LICSW)
(401) 553-1000
Entity
Organization
Contact information
Practice address
249 ROOSEVELT AVE, SUITE 205, PAWTUCKET, RI 02860-2134
(401) 724-8400
(401) 365-1100
Mailing address
1516 ATWOOD AVE, JOHNSTON, RI 02919-3223
(401) 553-1000
(401) 553-1143
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW000702
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70579792
—
RI
Enumeration date
07/12/2006
Last updated
08/22/2020
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