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Organization

RITE OF PASSAGE INC

Active
Parent organization
RITE OF PASSAGE, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
RITE OF PASSAGE, INC
Authorized official
RUSTY E. ALEXANDER (BUSINESS MANAGING DIRECTOR)
(775) 392-2639
Entity
Organization

Contact information

Practice address
3304 E I 80 SERVICE RD, CHEYENNE, WY 82009-8781
(307) 829-7355
Mailing address
2560 BUSINESS PKWY STE A, MINDEN, NV 89423-8961
(775) 392-2657
(775) 392-2455

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
261QM0855X
Adolescent and Children Mental Health Clinic/Center
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
323P00000X
Psychiatric Residential Treatment Facility

Other

Enumeration date
09/19/2018
Last updated
08/22/2023
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