CANYON STATE ACADEMY
NPI 1346766953
Residential Treatment Facility, Emotionally Disturbed Children in Queen Creek, AZ

Q: What is Rite Of Passage, Inc.'s NPI number?

The NPI number for Rite Of Passage, Inc. is 1346766953. It was assigned to this organization in the NPPES registry on August 15, 2017. The provider is doing business as Canyon State Academy.

Q: What is Rite Of Passage, Inc.'s specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Active since August 15, 2017CLIA 03D2342479 · Waiver

20061 E RITTENHOUSE RD, QUEEN CREEK, AZ 85142(480) 987-2047 Get Directions Write a Review

NPPES record last updated: March 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 27, 2021, Jan 10, 2019, Aug 15, 2017 (3 updates tracked since 2017).

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About Canyon State Academy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANYON STATE ACADEMY (NPI 1346766953) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Queen Creek, Arizona and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through April 20, 2028 and lists Rusty E. Alexander, Business Managing Director, as its authorized official.

NPPES Registry Identity

NPI1346766953

Entity TypeOrganization

Primary Taxonomy322D00000X

Legal Business NameRITE OF PASSAGE, INC.

Location Address20061 E RITTENHOUSE RDQueen Creek, AZ 85142-9715

Mailing Address20275 E Rittenhouse Rd Ste 105Queen Creek, AZ 85142-1661 · (480) 987-2053

Phone(480) 987-2047

Organization SubpartYesParent: Rite Of Passage Inc

Authorized OfficialRusty E. AlexanderBusiness Managing Director · (775) 392-2639

Enumeration DateAugust 15, 2017

Last NPPES UpdateMarch 15, 20243 updates tracked since enumeration

NPPES CertifiedMarch 15, 2024

✔ NPI 1346766953 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities

Taxonomy Code322D00000X

Definition

A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X · License CSLG6685 (AZ)

20061 E RITTENHOUSE RD, Queen Creek, AZ 85142

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Other Names 1

Doing Business AsCanyon State Academy

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2342479

Canyon State Academy · Queen Creek, AZ

Active · expires Apr 20, 2028

CLIA Number03D2342479

Laboratory TypeQualified Residential Tre

Certificate Effective DateApril 21, 2026

Certificate Expiration DateApril 20, 2028

Laboratory DirectorBrittany Thomas

Laboratory Phone(480) 987-9700

Laboratory LocationCanyon State Academy20061 E Rittenhouse Rd, Queen Creek, AZ 85142

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE MARIE KLYM B.S., SLP-A

Specialist/Technologist (Speech-Language Assistant)