LIFE GATEWAY (NPI# 1710246921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710246921 |
| Entity Type | Organization |
| Organization Name | LIFE GATEWAY |
| Practice Address |
2128 Pink Coral Dr North Las Vegas NV 89031-0985 |
| Mailing Address |
3605 Mountain Crest St Las Vegas NV 89129-7864 |
| Practice Telephone | 7022349822 |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2012-05-08 |
| Authorized Official Name | CYNTHIA EWELL (MANAGING MEMBER) |
| Authorized Official Telephone | 7027529274 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
NV | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649604554 | Life Gateway | Behavioral Analyst | 7548 W Sahara Ave Ste 101, Las Vegas, NV 89117-2779 | 2013-08-27 |
| 1992142186 | Life Gateway | Community/Behavioral Health | 7548 W Sahara Ave, Las Vegas, NV 89117-2778 | 2013-05-28 |
| 1376977280 | Life Gateway | Behavioral Analyst | 7548 W Sahara Ave, Suite 101, Las Vegas, NV 89117-2778 | 2013-08-27 |
| Street Address |
2128 PINK CORAL DR |
| City | NORTH LAS VEGAS |
| State | NV |
| Zip Code | 89031-0985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740684984 | Sunridge Enterprise Inc. | Community Based Residential Treatment Facility, Mental Illness | 2128 Pink Coral Dr, North Las Vegas, NV 89031-0985 | 2014-10-17 |
| 1811323868 | Lindsey Fujieki | Social Worker | 2128 Pink Coral Dr, North Las Vegas, NV 89031-0985 | 2013-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265071039 | Dimuro Facilities Services | Pain Medicine | Dimuro Pain Management, 3970 W Ann Road Ste 100, N Las Vegas, NV 89031 | 2019-12-27 |
| 1225681323 | Jasmine Coleman | Home Health Aide | 1517 Santa Rosalia Dr., North Las Vegas, NV 89031 | 2019-07-18 |
| 1558924134 | Jamie Esprecion | Driver | 3007 Extravagant Ave, North Las Vegas, NV 89031 | 2019-04-18 |
| 1831652387 | Assured Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 4461 North Decatur Blvd, Ste 110, N Las Vegas, NV 89031 | 2019-04-11 |
| 1265928550 | Geraldine Alford | Chore Provider | 5150 El Camino Norte Suite 150, Las Vegas, NV 89031 | 2018-07-10 |
| 1861999468 | Danielle Anderson | Counselor | 4528 West Craig Suite 150, Las Vegas, NV 89031 | 2018-04-10 |
| 1871094078 | Ethel Richardson | Chore Provider | 620 Manuel Edwardo Ave, N. Las Vegas, NV 89031 | 2018-02-22 |
| 1124547997 | Crystal Dorin Mcdowell | Counselor | 5920 Palmilla St Unit 5, North Las Vegas, NV 89031 | 2017-09-13 |
| 1699293308 | Mitzi Darnell Adeyemi | Counselor | 2205 Mountain Sunset Ave, North Las Vegas, NV 89031 | 2017-09-01 |
| 1831629500 | Emily Davis | Case Manager/Care Coordinator | 1926 La Villa Dr, North Las Vegas, NV 89031 | 2017-06-15 |
| Find all providers in zip 89031 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639501935 | Debora Cole | Psychologist | 2504 Clayton St, North Las Vegas, NV 89032-3802 | 2013-08-08 |
| 1679873996 | Karen Walker | Psychologist | 3624 Russian Olive St, North Las Vegas, NV 89032-7643 | 2010-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002964 | Andrew Justin Freeman | Psychologist | 1485 W Warm Springs Rd Ste 109, Henderson, NV 89014-7632 | 2020-10-28 |
| 1104437946 | Coates & Doran, Pllc | Psychologist | 1812 Marian Ave, Carson City, NV 89706-2632 | 2020-08-14 |
| 1316495583 | Each Child An Achiever Corporation | Psychologist | 1225 E Hacienda Ave, #2, Las Vegas, NV 89119-5027 | 2016-09-16 |
| 1730505553 | Alexis Manning-espinda | Psychologist | 1550 Lorilyn Ave Unit 2, Las Vegas, NV 89119-7662 | 2014-03-17 |
| 1588087860 | Tonya Cooper | Psychologist | 2701 N Decatur Blvd Apt 1055, Las Vegas, NV 89108-2969 | 2014-01-22 |
| 1609298256 | Cynthia Bolden | Psychologist | 1957 Susan St, Las Vegas, NV 89106-2654 | 2014-01-16 |
| 1700217031 | Adrian Brown | Psychologist | 5824 W Oakey Blvd, Las Vegas, NV 89146-1243 | 2013-12-12 |
| 1730523572 | Samantha Christine Flores | Psychologist | 1651 American Pacific Dr, Unit#2303, Henderson, NV 89074-7601 | 2013-04-23 |
| 1275871238 | Porscha Menyweather | Psychologist | 4316 E Tropicana Ave, Las Vegas, NV 89121-6704 | 2013-01-26 |
| 1689918054 | Tangy Denise Goffner | Psychologist | 1129 W Monroe Ave, Las Vegas, NV 89106-2914 | 2012-11-24 |
| Find all providers with the same taxonomy | ||||
| City | NORTH LAS VEGAS |
| Zip Code | 89031 |
Please comment or provide details below to improve the information on LIFE GATEWAY.
| 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.