Organization
GATEWAY HIGH SCHOL
Active
Parent organization
DUNAMIS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DUNAMIS, INC
Authorized official
MR. ORLANDO GILLAM (CHIEF EXECUTIVE OFFICER)
(559) 981-2143
Entity
Organization
Contact information
Practice address
1550 HERNDON AVE, CLOVIS, CA 93611-0569
(559) 327-1800
Mailing address
1550 HERNDON AVE, CLOVIS, CA 93611-0569
(559) 327-1800
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
100091AN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962637512
MEDI CAL
CA
Enumeration date
04/09/2014
Last updated
04/09/2014
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