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Organization

GATEWAY DETROIT

Active
Parent organization
GATEWAY
Organization subpart
Yes

Provider details

NPI number
Legal business name
GATEWAY
Authorized official
FREDERICK CARR B.S.,S.S.T (SOCIAL WORKER/CASE MANAGER)
(313) 331-3435
Entity
Organization

Contact information

Practice address
11457 SHOEMAKER ST, DETROIT, MI 48213-3418
(313) 331-3435
(313) 924-0609
Mailing address
11457 SHOEMAKER ST, DETROIT, MI 48213-3418
(313) 331-3435
(313) 924-0609

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
6803086187
MI

Other

Enumeration date
08/06/2014
Last updated
08/06/2014
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