GATEWAY RESIDENTIAL SERVICES, INC. (NPI# 1508905324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508905324 |
| Entity Type | Organization |
| Organization Name | GATEWAY RESIDENTIAL SERVICES, INC. |
| Practice Address |
701 14th St S Benson MN 56215-1902 |
| Practice Telephone | 3208434808 |
| Mailing Telephone | 3208434808 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DEBRA SHRIVER (CFO) |
| Authorized Official Telephone | 3202312738 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | MN | Residential Treatment Facilities |
| Street Address |
701 14TH ST S |
| City | BENSON |
| State | MN |
| Zip Code | 56215-1902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316157944 | Jonell Elizabeth Schmidt | Counselor | 380 55th Ave Nw, Benson, MN 56215 | 2007-05-23 |
| 1124111745 | Jennifer Lynn Westrum | Counselor | 640 Atlantic Avenue, Benson, MN 56215 | 2006-10-02 |
| 1306984497 | Claudette M Larson | Social Worker | 640 Atlantic Ave, Benson, MN 56215 | 2007-02-02 |
| 1366419723 | Mary J Felt | Nurse Practitioner | 1805 Wisconsin Ave, Benson, MN 56215 | 2006-03-03 |
| 1962478289 | Richard R Horecka | Family Medicine | 1805 Wisconsin Ave, Benson, MN 56215 | 2006-02-27 |
| 1710953443 | Karen T Dorn | Internal Medicine | 1805 Wisconsin Ave, Benson, MN 56215 | 2006-02-23 |
| 1639145402 | Rachel A Wilcox | Nurse Practitioner | 1805 Wisconsin Ave, Benson, MN 56215 | 2006-02-23 |
| 1346578051 | Swift County Human Services Agency | Community/Behavioral Health | 410 21st Street S, Benson, MN 56215-0208 | 2009-11-19 |
| 1518918846 | Ggnsc Benson LLC | Skilled Nursing Facility | 2209 Utah Ave, Benson, MN 56215-1000 | 2006-05-12 |
| 1306468111 | Swift Benson Holdings LLC | Skilled Nursing Facility | 2209 Utah Ave, Benson, MN 56215-1000 | 2020-05-14 |
| Find all providers in zip 56215 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811344708 | Bubbles of Fun Developmental Therapy | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 50 Eagle Rd, Benson, NC 27504-7256 | 2016-05-20 |
| 1851629224 | Aava Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 603 S Wall St, Benson, NC 27504-1823 | 2009-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184244527 | Kam Homecare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1500 Nicollet Ave Apt 305, Minneapolis, MN 55403-2724 | 2020-04-24 |
| 1477117885 | Kelly Rae Martin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13881 Schuelke Beach Rd Nw, Miltona, MN 56354 | 2019-05-01 |
| 1295291573 | Tricia Bastian | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 607 4th St S, Walker, MN 56484-6400 | 2019-02-12 |
| 1881163632 | Jacob Wrich | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 603 3rd St W Apt 1, Hastings, MN 55033-1127 | 2018-11-21 |
| 1003394479 | Malissa Ann Costanzo | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 844 8th Ave Se, Forest Lake, MN 55025 | 2018-07-30 |
| 1154814564 | Laurie K. Tazelaar-williams | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5253 W Bald Eagle Blvd, White Bear Lake, MN 55110-6532 | 2018-06-11 |
| 1205340577 | Dale Conrad Forslin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1029 Highway 65 Ste 107, Braham, MN 55006-3360 | 2017-11-25 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| 1407396336 | Viko Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5651 69th Ave N, 203, Brooklyn Park, MN 55429-1579 | 2017-02-25 |
| 1972052702 | Marie-noel Hiol-hiol | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14642 Quartz Ter Nw, Ramsey, MN 55303-4581 | 2016-09-21 |
| Find all providers with the same taxonomy | ||||
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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.