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General NPI Number Information
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NPI Number | 1144752841
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Entity Type | Organization
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Legal Business Name | RITE OF PASSAGE INC
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Dates
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Enumeration Date | 03/31/2017
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 216 CENTERVIEW DR SUITE 317
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City | BRENTWOOD
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State | TN
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Zip | 37027-3226
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Country | US
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Telephone | 775-392-2636
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Fax |
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Provider Business Mailing Address
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Address Line | 2560 BUSINESS PKWY SUITE A
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City | MINDEN
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State | NV
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Zip | 89423-8985
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Country | US
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Telephone | 775-392-2636
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Fax | 775-392-2450
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Authorized Official
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Title or Position | PRESIDENT/ CEO
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Name | SKI JAMES BROMAN
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Credential |
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Telephone | 775-267-9411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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