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General NPI Number Information
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NPI Number | 1962935379
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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 | 04/04/2017
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Last Update Date | 04/04/2017
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Provider Practice Location Address
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Address Line | 8810 HIGHWAY 103
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City | IDAHO SPRINGS
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State | CO
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Zip | 80452-9623
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Country | US
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Telephone | 303-408-4355
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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 | 303-408-4355
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | ROBYN HAINLINE
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Credential |
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Telephone | 303-408-4355
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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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