1134830995 NPI number — RITE OF PASSAGE ADOLESCENT TREATMENT CENTERS AND SCHOOLS INC.

Table of content: DR. JOSE ANDRES ROIG MD (NPI 1710338629)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134830995 NPI number — RITE OF PASSAGE ADOLESCENT TREATMENT CENTERS AND SCHOOLS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RITE OF PASSAGE ADOLESCENT TREATMENT CENTERS AND SCHOOLS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
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Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
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NPI Number Information

NPI Number:
1134830995
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2560 BUSINESS PKWY STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINDEN
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89423-8961
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-267-9411
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10400 FRICOT CITY RD UNIT M
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANDREAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95249-9642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-392-2659
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2022

Additional Information

Authorized Official

Authorized Official Last Name:
CARTER
Authorized Official First Name:
NANCEY
Authorized Official Middle Name:
Authorized Official Title or Position:
BEHAVIORAL HEALTH COMPLIANCE DIR
Authorized Official Telephone Number:
480-987-2053

Provider Taxonomy Codes

  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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