| Gateways Recovery Inc | |
|
4966 Glenway Ave Cincinnati OH 45238-3905 | |
| (513) 684-7955 | |
| Not Available |
| Full Name | Gateways Recovery Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4966 Glenway Ave, Cincinnati, Ohio |
| Authorized Official Name and Position | Carla Brooks (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5137517747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateways Recovery Inc 2600 Victory Pkwy Cincinnati OH 45206-1711 Ph: (513) 751-7747 | Gateways Recovery Inc 4966 Glenway Ave Cincinnati OH 45238-3905 Ph: (513) 684-7955 |
| NPI Number | 1265453930 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 03/17/2021 |
| Certification Date | 03/17/2021 |
| Medicare PECOS PAC ID | 7315914199 |
|---|---|
| Medicare Enrollment ID | O20040911000333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265453930 | NPI | - | NPPES |
| 0099942 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
| Provider Name | Janecia L King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558554014 PECOS PAC ID: 1951470509 Enrollment ID: I20080521000949 |
| Provider Name | Keshia Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568706307 PECOS PAC ID: 0648416339 Enrollment ID: I20130425000299 |
| Provider Name | Marina T Wolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659642023 PECOS PAC ID: 8527297233 Enrollment ID: I20140129000566 |
| Provider Name | Andrea R Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801210703 PECOS PAC ID: 4284864554 Enrollment ID: I20140306000432 |
| Provider Name | Nicole D Althof-campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659565265 PECOS PAC ID: 1951646108 Enrollment ID: I20181217002907 |
| Provider Name | Jeremy J Toras |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265887541 PECOS PAC ID: 3274879341 Enrollment ID: I20190110000376 |
| Provider Name | Cathy A Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629477039 PECOS PAC ID: 3971827544 Enrollment ID: I20201204001522 |
| Provider Name | Jessica Tubbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457712747 PECOS PAC ID: 2567847338 Enrollment ID: I20220914002221 |
| Provider Name | Osagie Ekhator |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437867165 PECOS PAC ID: 4385017821 Enrollment ID: I20230302001772 |
| Provider Name | Alexander Grigg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306219340 PECOS PAC ID: 4082065362 Enrollment ID: I20240111000840 |
| Provider Name | Ervin Henderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831676634 PECOS PAC ID: 4880037258 Enrollment ID: I20240213002812 |
| Provider Name | Justin W Cova |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851904007 PECOS PAC ID: 8527406347 Enrollment ID: I20240329000438 |
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