1811659378 NPI number — RITE OF PASSAGE ADOLESCENT TREATMENT CENTERS AND SCHOOLS INC.

Table of content: (NPI 1811659378)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811659378 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:
Provider Other Middle Name:
Provider Other Name Prefix Text:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1811659378
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20275 E RITTENHOUSE RD STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
QUEEN CREEK
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85142-1661
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-987-2053
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1693 NADOWA STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH LAKE TAHOE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96150-9615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-573-1544
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2021

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
Authorized Official Telephone Number:
602-265-2000

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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