Provider Demographics
NPI:1568549111
Name:RITE OF PASSAGE ATHLETIC TRAINING CENTERS & SCHOOLS, INC.
Entity Type:Organization
Organization Name:RITE OF PASSAGE ATHLETIC TRAINING CENTERS & SCHOOLS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-267-9411
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:
Mailing Address - Fax:
Practice Address - Street 1:100 ROSASCHI RD
Practice Address - Street 2:
Practice Address - City:YERINGTON
Practice Address - State:NV
Practice Address - Zip Code:89447-8722
Practice Address - Country:US
Practice Address - Phone:775-463-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101YP2500X, 171M00000X, 251S00000X
322D00000X, 323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100508202Medicaid
NV100508204Medicaid
NV100508205Medicaid
NV100508203Medicaid
NV100508201Medicaid
NV100508206Medicaid
NV100508207Medicaid