Provider Demographics
NPI:1144752841
Name:RITE OF PASSAGE INC
Entity Type:Organization
Organization Name:RITE OF PASSAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:SKI
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BROMAN
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:775-392-2636
Mailing Address - Fax:775-392-2450
Practice Address - Street 1:216 CENTERVIEW DR
Practice Address - Street 2:SUITE 317
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3226
Practice Address - Country:US
Practice Address - Phone:775-392-2636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children