Organization
GATEWAY RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN GRAVES (PRESIDENT)
(719) 641-3827
Entity
Organization
Contact information
Practice address
3338 ASH MESA RD, DELTA, CO 81416-8766
(970) 209-8691
(866) 799-7523
Mailing address
3346 ASH MESA RD, DELTA, CO 81416-8766
(970) 209-8691
(866) 799-7523
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
1609500
CO
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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