NPIMap

Organization Active NPI

Rite of Passage, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Queen Creek, AZ
National Provider Identifier
1346766953
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
RITE OF PASSAGE, INC.
Doing business as
Canyon State Academy
Practice address
20061 E Rittenhouse Rd
Queen Creek, AZ 85142-9715
Phone
(480) 987-2047
NPI assigned
Aug 15, 2017
Organization subpart
Yes
Parent organization
RITE OF PASSAGE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rusty E. Alexander
Title
Business Managing Director
Phone
(775) 392-2639

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X CSLG6685 AZ
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

20061 E Rittenhouse Rd
Queen Creek, AZ 85142-9715

Mailing address

20275 E Rittenhouse Rd Ste 105
Queen Creek, AZ 85142-1661
Phone (480) 987-2053

Other names 1

  • Canyon State Academy Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2342479Canyon State Academy20061 E Rittenhouse Rd, Queen Creek, AZ 85142Certificate of waiverApr 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
Rite of Passage Inc42 organizations share this tax ID, including this one
Part of
Rite of Passage Inc

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1346766953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20275 E RITTENHOUSE RD STE 105",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421661",
            "telephone_number": "480-987-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20061 E RITTENHOUSE RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429715",
            "telephone_number": "480-987-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE OF PASSAGE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RITE OF PASSAGE INC",
        "enumeration_date": "2017-08-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "RUSTY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "BUSINESS MANAGING DIRECTOR",
        "authorized_official_telephone_number": "775-392-2639"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "AZ",
            "license": "CSLG6685",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon State Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.