Organization
GATEWAY TO SUCCESS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN S MORGENTHALER LCSW, LAC (EXECUTIVE DIRECTOR)
(719) 564-5070
Entity
Organization
Contact information
Practice address
602 YALE PL, CANON CITY, CO 81212-4611
(719) 275-0700
(719) 896-2874
Mailing address
PO BOX 1748, CANON CITY, CO 81215-1748
(719) 275-0700
(719) 896-2874
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90000125324
—
CO
Enumeration date
04/20/2016
Last updated
08/30/2019
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