Provider Demographics
NPI:1265721328
Name:RITE OF PASSAGE
Entity type:Organization
Organization Name:RITE OF PASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUSTY
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-392-2639
Mailing Address - Street 1:2560 BUSINESS PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-8985
Mailing Address - Country:US
Mailing Address - Phone:775-267-9411
Mailing Address - Fax:775-267-9409
Practice Address - Street 1:2560 BUSINESS PKWY STE B
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-8961
Practice Address - Country:US
Practice Address - Phone:775-267-9411
Practice Address - Fax:775-267-9409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty