Gateway Professional Services, Pc | |
2200 Lake Victoria Dr Springfield IL 62703-5596 | |
(877) 381-6538 | |
Not Available |
Full Name | Gateway Professional Services, Pc |
---|---|
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 2200 Lake Victoria Dr, Springfield, Illinois |
Authorized Official Name and Position | Roueen Rafeyan (PRESIDENT) |
Authorized Official Contact | 3126631130 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gateway Professional Services, Pc 55 E Jackson Blvd Ste 1500 Chicago IL 60604-4184 Ph: (312) 663-1130 | Gateway Professional Services, Pc 2200 Lake Victoria Dr Springfield IL 62703-5596 Ph: (877) 381-6538 |
NPI Number | 1285272591 |
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Provider Enumeration Date | 12/17/2019 |
Last Update Date | 06/14/2024 |
Certification Date | 06/14/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285272591 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
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