OrganizationGateway Community Initiative, IncCommunity/Behavioral HealthAgenciesPractice Address111 Windel Dr, 205, Raleigh, NC 27609-4475(919) 896-4380PECOS EnrollmentBased on the most recent information from CMS, provider Gateway Community Initiative, Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1104130632Provider TypeOrganizationFull NameGateway Community Initiative, IncSubpartNoEnumeration Date7/26/2010Last Updated7/26/2010Contact InformationPractice LocationPractice Address111 Windel Dr, 205, Raleigh, NC 27609-4475Phone(919) 896-4380Fax(800) 991-0902Mailing LocationMailing Address2510 Garden Hill Dr, 303, Raleigh, NC 27614-6899Phone(919) 896-4380Fax(800) 991-0902Authorized OfficialNameParker, Angela S (Clinical Director)Phone(919) 896-4380Provider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted IssuerNorth CarolinaCode251V00000XDescriptionVoluntary or CharitableAgenciesLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID6112104DescriptionMedicaidIssuerUnlistedNorth Carolina