Healthcare Provider Details
I. General information
NPI: 1619585197
Provider Name (Legal Business Name): RITE OF PASSAGE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2020
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5924 US HIGHWAY 285
MORRISON CO
80465-9101
US
IV. Provider business mailing address
2560 BUSINESS PKWY STE A
MINDEN NV
89423-8961
US
V. Phone/Fax
- Phone: 303-697-0235
- Fax:
- Phone: 775-392-2657
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 322D00000X |
| Taxonomy | Emotionally Disturbed Childrens' Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARANDA
J
FIGULI
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 480-987-2080