Provider Demographics
NPI:1528543212
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:TUSTIN FAMILY CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUSTY
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-392-2639
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:775-392-2657
Mailing Address - Fax:775-392-2455
Practice Address - Street 1:15405 LANSDOWNE RD STE C
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-0201
Practice Address - Country:US
Practice Address - Phone:714-258-7710
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:2018-09-27
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health