Organization
GATEWAY INTEGRATIVE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONTAVIUS KENTWAN BIBBS (ADMINISTRATOR)
(404) 593-1320
Entity
Organization
Contact information
Practice address
2470 EMERALD PL, SUITE A, GREENVILLE, NC 27834-5786
(404) 593-1320
(252) 321-4829
Mailing address
PO BOX 20702, GREENVILLE, NC 27858-0702
(404) 593-1320
(252) 321-4829
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/05/2009
Last updated
08/05/2009
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