Organization
GATEWAY HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE FACTEAU (CREDENTIALING COORDINATOR)
(401) 724-8400
Entity
Organization
Contact information
Practice address
58 HAMLET AVE, WOONSOCKET, RI 02895-4423
(401) 765-4040
(401) 658-3757
Mailing address
249 ROOSEVELT AVE, SUITE 205, PAWTUCKET, RI 02860-2134
(401) 724-8400
(401) 365-1100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LCDP
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FACILITY CONTRACT
—
RI
Enumeration date
06/24/2006
Last updated
08/22/2020
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