GATEWAY ADDICTIONOLOGY SERVICES, PLLC (NPI# 1699221879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699221879 |
| Entity Type | Organization |
| Organization Name | GATEWAY ADDICTIONOLOGY SERVICES, PLLC |
| Other Organization Name | GATEWAY RECOVERY INSTITUTE |
| Practice Address |
4862 E. Baseline Road Suite 108 Mesa AZ 85206 |
| Mailing Address |
4838 E. Baseline Road Suite 108 Mesa AZ 85206-4672 |
| Practice Telephone | 4809812405 |
| Practice Fax Number | 4809812407 |
| Mailing Telephone | 4809812400 |
| Mailing Fax Number | 4809812407 |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | BRIAN J. DELISIO (PRESIDENT/CEO) |
| Authorized Official Telephone | 4809812405 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LA0401X |
Anesthesiology Specialization: Addiction Medicine |
43504 | AZ | Allopathic & Osteopathic Physicians |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | BH5407 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | NPI | 1699221879 | 01 |
| Other Name | Type Code |
|---|---|
| Gateway Recovery Institute | Doing Business As Name - Organization |
| Street Address |
4862 E. BASELINE ROAD SUITE 108 |
| City | MESA |
| State | AZ |
| Zip Code | 85206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295281863 | Kurefusion, Pllc | Anesthesiology | 4862 E. Baseline Road, Suite 108, Mesa, AZ 85206-4668 | 2016-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| 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 |
|---|---|---|---|---|
| 1073179883 | Dara II Inc | Substance Abuse Rehabilitation Facility | 4645 E Ellis Cir, Mesa, AZ 85205-5238 | 2019-05-16 |
| 1417458753 | Reboot Detox Az LLC | Substance Abuse Rehabilitation Facility | 1132 S Oakland, Mesa, AZ 85206-2682 | 2018-02-22 |
| 1326491283 | Soba Mesa LLC | Substance Abuse Rehabilitation Facility | 6215 E Arbor Ave, Mesa, AZ 85206-6064 | 2016-07-15 |
| 1841649258 | Big Sky Recovery LLC | Substance Abuse Rehabilitation Facility | 2360 N Robin Ln, Mesa, AZ 85213-2474 | 2016-06-07 |
| 1104209352 | Recovery Homes, Inc | Substance Abuse Rehabilitation Facility | 141 South Center Street, Suite B, Mesa, AZ 85210 | 2015-07-07 |
| 1710369483 | Recovery Homes, Inc | Substance Abuse Rehabilitation Facility | 143 S Center St, Suite A, Mesa, AZ 85210-1307 | 2015-06-18 |
| 1306243084 | Residents At The Heights LLC | Substance Abuse Rehabilitation Facility | 215 S Power Rd Ste 1251, Mesa, AZ 85206-5238 | 2014-11-25 |
| 1538599469 | The River Source Iop LLC | Substance Abuse Rehabilitation Facility | 128 W Pepper Pl, Mesa, AZ 85201-7317 | 2013-11-13 |
| 1578807145 | Recovery Help, LLC. | Substance Abuse Rehabilitation Facility | 3945 E Broadway Rd, Mesa, AZ 85206-1030 | 2012-11-20 |
| 1497833644 | Anasazi Foundation | Substance Abuse Rehabilitation Facility | 1424 S Stapley Dr, Mesa, AZ 85204-5877 | 2006-11-02 |
| Find all providers in MESA | ||||
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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.