Organization
GATEWAY HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY NIXON LCDS (LCDS)
(401) 766-1665
Entity
Organization
Contact information
Practice address
80 HAMLET AVE, WOONSOCKET, RI 02895-4410
(401) 766-1665
(401) 767-4903
Mailing address
249 ROOSEVELT AVE, SUITE 205, PAWTUCKET, RI 02860-2134
(401) 724-8400
(401) 365-1100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDS
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FACILITY CONTRACT
—
RI
Enumeration date
07/10/2006
Last updated
08/22/2020
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