National Provider Identifier Database

GATEWAY ADDICTIONOLOGY SERVICES PLLC
Substance Abuse Disorder 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.


Contact Information

GATEWAY ADDICTIONOLOGY SERVICES, PLLC
4862 E. BASELINE ROAD
SUITE 108
MESA, AZ85206
Phone: 480-981-2405
Fax: 480-981-2407
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X
Addiction Medicine 207LA0401X

* Indicates primary specialty

NPI Profile & details for GATEWAY ADDICTIONOLOGY SERVICES, PLLC

NPI Number 1699221879
Legal business name
LBN
GATEWAY ADDICTIONOLOGY SERVICES, PLLC
Authorized official BRIAN DELISIO - (PRESIDENT/CEO)
Entity Organization
Organization subpart No
Enumeration date 08/29/2016
Last updated 06/21/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: 43504
  • AZ License #: BH5407
  • AZ Other: 1699221879 NPI

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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