Provider Demographics
NPI:1073993002
Name:RITE OF PASSAGE, INC.
Entity Type:Organization
Organization Name:RITE OF PASSAGE, INC.
Other - Org Name:DEPAUL ACADEMY
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS-BOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-267-9411
Mailing Address - Street 1:2560 BUSINESS PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-8985
Mailing Address - Country:US
Mailing Address - Phone:775-267-9411
Mailing Address - Fax:775-392-2450
Practice Address - Street 1:1000 S MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-3426
Practice Address - Country:US
Practice Address - Phone:574-339-4419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children