| Gateway To Prevention & Recovery Chandler | |
|
111 W 1st St Chandler OK 74834-2004 | |
| (405) 273-1170 | |
| (405) 241-6447 |
| Full Name | Gateway To Prevention & Recovery Chandler |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 111 W 1st St, Chandler, Oklahoma |
| Authorized Official Name and Position | Jon Greenwood (CEO) |
| Authorized Official Contact | 4052731170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway To Prevention & Recovery Chandler 36609 45th St Shawnee OK 74804-8882 Ph: (405) 273-1170 | Gateway To Prevention & Recovery Chandler 111 W 1st St Chandler OK 74834-2004 Ph: (405) 273-1170 |
| NPI Number | 1205275302 |
|---|---|
| Provider Enumeration Date | 06/21/2013 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205275302 | NPI | - | NPPES |
| 100736990D | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |