Provider Demographics
NPI:1922424076
Name:RITES OF PASSAGE
Entity Type:Organization
Organization Name:RITES OF PASSAGE
Other - Org Name:GTEWAYS TO TRANSFORMATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER, HEAD COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ADRIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-859-7385
Mailing Address - Street 1:4979 4200 RD.
Mailing Address - Street 2:
Mailing Address - City:CRAWFORD
Mailing Address - State:CO
Mailing Address - Zip Code:81415
Mailing Address - Country:US
Mailing Address - Phone:970-921-4563
Mailing Address - Fax:970-921-5420
Practice Address - Street 1:4879 GATEWAY RD.
Practice Address - Street 2:
Practice Address - City:CRAWFORD
Practice Address - State:CO
Practice Address - Zip Code:81415
Practice Address - Country:US
Practice Address - Phone:970-921-4563
Practice Address - Fax:970-921-5420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC1900X
COLPC0011272320800000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Multi-Specialty