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Organization

GATEWAY PROGRAM, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERIC JOHN SPAGENSKI LICSW (CEO)
(507) 244-1303
Entity
Organization

Contact information

Practice address
3117 11 1/2 AVE NW, ROCHESTER, MN 55901-1474
(507) 244-1303
Mailing address
3117 11 1/2 AVE NW, ROCHESTER, MN 55901-1474
(507) 244-1303

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary

Other

Enumeration date
03/22/2018
Last updated
11/11/2024
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