Provider Demographics
NPI:1619585197
Name:RITE OF PASSAGE, INC.
Entity Type:Organization
Organization Name:RITE OF PASSAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGING 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 A
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:
Practice Address - Street 1:5924 US HIGHWAY 285
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:CO
Practice Address - Zip Code:80465-9101
Practice Address - Country:US
Practice Address - Phone:303-697-0235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RITE OF PASSAGE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children