| NPI | 1912743899 |
|---|---|
| Former Legal Business Name | GATEWAY WELNESS |
| Entity Type | Organization |
| Authorized Contact | SUHABE H JAMA President 612-458-4191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-07-01 |