| Gateway Behavioral Health Llc | |
|
6500 Manton Way Lanham MD 20706-2487 | |
| (240) 505-5427 | |
| Not Available |
| Full Name | Gateway Behavioral Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6500 Manton Way, Lanham, Maryland |
| Authorized Official Name and Position | Grace Doh (PRESIDENT) |
| Authorized Official Contact | 2405055427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Behavioral Health Llc 6500 Manton Way Lanham MD 20706-2487 Ph: (240) 505-5427 | Gateway Behavioral Health Llc 6500 Manton Way Lanham MD 20706-2487 Ph: (240) 505-5427 |
| NPI Number | 1598367880 |
|---|---|
| Provider Enumeration Date | 11/11/2020 |
| Last Update Date | 01/26/2021 |
| Medicare PECOS PAC ID | 6608280730 |
|---|---|
| Medicare Enrollment ID | O20210201000083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598367880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Grace Doh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255994802 PECOS PAC ID: 3274868914 Enrollment ID: I20200102001185 |
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