Organization
GATEWAY RESIDENTIAL PROGRAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BEESLEY LMFT (EXECUTIVE DIRECTOR)
(916) 782-1111
Entity
Organization
Contact information
Practice address
1780 VERNON ST STE 1, ROSEVILLE, CA 95678-6311
(916) 782-1111
(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
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
09/07/2022
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