Organization
GATEWAY RECOVERY CENTER II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MICHELE GOODE LADC, MBA (EXECUTIVE DIRECTOR)
(651) 587-7181
Entity
Organization
Contact information
Practice address
6840 78TH AVE N, BROOKLYN PARK, MN 55445-2760
(651) 587-7181
Mailing address
1663 CELIA RD, MENDOTA HEIGHTS, MN 55118-3604
(651) 698-7358
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
05/18/2023
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