Provider Demographics
NPI:1487322954
Name:RITE OF PASSAGE INC
Entity type:Organization
Organization Name:RITE OF PASSAGE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BEHAV HEALTH COMPLIANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:480-987-2053
Mailing Address - Street 1:20275 E RITTENHOUSE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-1661
Mailing Address - Country:US
Mailing Address - Phone:480-987-2053
Mailing Address - Fax:
Practice Address - Street 1:20275 E RITTENHOUSE RD STE 105
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-1661
Practice Address - Country:US
Practice Address - Phone:480-987-2053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RITE OF PASSAGE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-31
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management