Provider Demographics
NPI:1689260788
Name:RITE OF PASSAGE INC
Entity Type:Organization
Organization Name:RITE OF PASSAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAV HEALTH COMPLIANCE DIRECTOR
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 1:28101 E QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:WATKINS
Mailing Address - State:CO
Mailing Address - Zip Code:80137-9502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1520 N UNION BLVD STE 204
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2840
Practice Address - Country:US
Practice Address - Phone:844-493-2855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RITE OF PASSAGE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health