| NPI | 1356587224 |
|---|---|
| Other Name | GATEWAY BHS - 63RD OUTPATIENT |
| Entity Type | Organization |
| Authorized Contact | WILLIAM PARKS Chief Financial Officer 912-554-8464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2008-12-26 |
| Last Update Date | 2011-10-20 |