OrganizationActive
Gateway to Rejuvenation
NPI 1407388812 · Community/Behavioral Health Agency · Portland, OR
Provider details
- NPI number
- 1407388812
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Omolola Elliott, Therapist(971) 212-3146
- License
- L7113 (OR)
Specialties & taxonomies
Agencies
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1312 E Burnside St
Portland, OR 97214-1424
Phone: (503) 205-1669
Street-level locationGet directions
Mailing address
3439 Ne Sandy Blvd Ste 216
Portland, OR 97232-1959
Registry dates
- Enumerated
- 2017-04-03
- Last updated
- 2017-04-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.