GATEWAY FOUNDATION, INC (NPI# 1699191700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699191700 |
| Entity Type | Organization |
| Organization Name | GATEWAY FOUNDATION, INC |
| Practice Address |
1080 E Park St West Wing Carbondale IL 62901-3812 |
| Mailing Address |
55 E Jackson Blvd Suite 1500 Chicago IL 60604-4466 |
| Practice Telephone | 6185291151 |
| Practice Fax Number | 6185499540 |
| Mailing Telephone | 3126631130 |
| Mailing Fax Number | 3126630504 |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2018-09-24 |
| Authorized Official Name | RENEE ENNIS MCGEE (MANAGER) |
| Authorized Official Telephone | 6784454833 |
| Is Organization Subpart | Y |
| Parent Organization Name | GATEWAY FOUNDATION, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | C/A-0538-0050-A | IL | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902456999 | Gateway Foundation, Inc | Clinic/Center | 4028 W. Dempster, Ste 100, Skokie, IL 60076 | 2019-09-12 |
| 1427349208 | Gateway Foundation, Inc | Clinic/Center | 2200 Lake Victoria Drive, Main Floor West, Springfield, IL 62703-5596 | 2011-04-27 |
| 1386779445 | Gateway Foundation, Inc | Substance Abuse Rehabilitation Facility | 55 E Jackson Blvd, Suite 1500, Chicago, IL 60604-4466 | 2007-02-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GATEWAY FOUNDATION, INC. | 4103 Lac Couture Dr, Harvey, LA 70058-6514 |
| Colorado Business Entities | Gateway Foundation, Inc. | 55 E. Jackson Blvd., Suite 1500, Chicago, IL 60604 |
| Massachusetts Corporations | GATEWAY FOUNDATION, INC. | 55 E. Jackson Blvd., Ste 1500, Chicago, IL 60604 |
| New York State Corporations | GATEWAY FOUNDATION, INC. | One Amy Kay Parkway, Po Box 1000c, Kingston, Ny 12401 |
| Ohio Business Entities | GATEWAY FOUNDATION, INC. | 55 East Jackson, Suite 1500, Chicago, IL 60604 |
| Vermont Business Registrations | GATEWAY FOUNDATION, INC. | No Principal Office, Brattleboro, VT 05302 |
| Indiana Business Entities | GATEWAY FOUNDATION, INCORPORATED | 55 E Jackson, Ste 1500, Chicago, IL 60604 |
| Street Address |
1080 E PARK ST WEST WING |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-3812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598914095 | Gateway Foundation, Inc. | Clinic/Center | 1080 E Park St, Carbondale, IL 62901-3812 | 2008-09-09 |
| 1982242368 | Gateway Professional Services, PC | Counselor | 1080 E Park St, Carbondale, IL 62901-3812 | 2019-12-16 |
| 1629635180 | Gateway Foundation, Inc. | Substance Abuse Rehabilitation Facility | 1080 E Park St, Carbondale, IL 62901-3812 | 2019-05-21 |
| 1043874829 | Sydney Lawrence | Counselor | 1080 E Park St, Carbondale, IL 62901-3812 | 2019-04-26 |
| 1326525668 | Tiffany D Allen | Social Worker | 1080 E Park St, Carbondale, IL 62901-3812 | 2018-07-19 |
| 1083102545 | Alejandra Q Corona | Social Worker | 1080 E Park St, Carbondale, IL 62901-3812 | 2018-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629635180 | Gateway Foundation, Inc. | Substance Abuse Rehabilitation Facility | 1080 E Park St, Carbondale, IL 62901-3812 | 2019-05-21 |
| 1750657482 | Jaywalker Lodge, Inc. | Substance Abuse Rehabilitation Facility | 725 Main St, Carbondale, CO 81623-1936 | 2012-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860729 | New Gen Ed Inc. | Substance Abuse Rehabilitation Facility | 1219 N Gary Ave, Carol Stream, IL 60188-9028 | 2020-10-28 |
| 1578187886 | Silver Glen Road Opco LLC | Substance Abuse Rehabilitation Facility | 41w400 Silver Glen Rd, St Charles, IL 60175-8453 | 2020-06-02 |
| 1669025672 | Gateway Foundation, Inc. | Substance Abuse Rehabilitation Facility | 25480 W Cedar Crest Ln Bldg A, Lake Villa, IL 60046-9744 | 2019-07-18 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1033673165 | Michael David Lauts | Substance Abuse Rehabilitation Facility | 215 E 25th St Apt 228, Sterling, IL 61081-1092 | 2019-01-23 |
| 1457829632 | Hope Behavioral Services At The Jeannine Brent Center Incorporated | Substance Abuse Rehabilitation Facility | 2319 Plainfield Rd, Crest Hill, IL 60403-1875 | 2018-11-06 |
| 1063989143 | Northwest Recovery Center LLC | Substance Abuse Rehabilitation Facility | 5352 N Lincoln Ave Ste 250, Chicago, IL 60625-2316 | 2018-10-26 |
| 1982182671 | Rosecrance, Inc. | Substance Abuse Rehabilitation Facility | 2835 N Sheffield Ave Ste 209, Chicago, IL 60657-5083 | 2018-08-03 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.