Provider Demographics
NPI:1497437040
Name:RITE OF PASSAGE ADOLESCENT TREATMENT CENTERS AND SCHOOLS, INC.
Entity Type:Organization
Organization Name:RITE OF PASSAGE ADOLESCENT TREATMENT CENTERS AND SCHOOLS, INC.
Other - Org Name:CYS RITE OF PASSAGE JOHNSON
Other - Org Type:Other Name
Authorized Official - Title/Position:BEHAVIORAL HEALTH COMPLIANCE DIR
Authorized Official - Prefix:
Authorized Official - First Name:NANCEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-987-2053
Mailing Address - Street 1:2560 BUSINESS PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-8961
Mailing Address - Country:US
Mailing Address - Phone:480-987-2053
Mailing Address - Fax:
Practice Address - Street 1:3068 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-2819
Practice Address - Country:US
Practice Address - Phone:714-454-7144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RITE OF PASSAGE ADOLESCENT TREATMENT CENTERS AND SCHOOLS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health