| Gateway Healthcare, Inc | |
|
249 Roosevelt Ave Suite 205 Pawtucket RI 02860-2134 | |
| (401) 724-8400 | |
| (401) 365-1100 |
| Full Name | Gateway Healthcare, Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 249 Roosevelt Ave, Pawtucket, Rhode Island |
| Authorized Official Name and Position | Marilyn Gaudioso (LICSW) |
| Authorized Official Contact | 4015531000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Healthcare, Inc 1516 Atwood Ave Johnston RI 02919-3223 Ph: (401) 553-1000 | Gateway Healthcare, Inc 249 Roosevelt Ave Suite 205 Pawtucket RI 02860-2134 Ph: (401) 724-8400 |
| NPI Number | 1346275880 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346275880 | NPI | - | NPPES |
| 70579792 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | ISW000702 (Rhode Island) | Primary |
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