Organization
GATEWAY RESIDENTIAL PROGRAMS HICKORY HOUSE
Active
Parent organization
GATEWAY RESIDENTIAL PROGRAMS
Organization subpart
Yes
Provider details
NPI number
Legal business name
GATEWAY RESIDENTIAL PROGRAMS
Authorized official
JEFF BEESLEY LMFT (EXECUTIVE DIRECTOR)
(916) 782-1111
Entity
Organization
Contact information
Practice address
7327 HICKORY AVE, ORANGEVALE, CA 95662-2426
(916) 721-1259
(916) 782-4544
Mailing address
1780 VERNON ST STE 1, ROSEVILLE, CA 95678-6311
(916) 782-1111
(916) 782-4544
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/17/2020
Last updated
09/07/2022
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