BOYS REPUBLIC (NPI# 1457700411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457700411 |
| Entity Type | Organization |
| Organization Name | BOYS REPUBLIC |
| Practice Address |
1907 Boys Republic Dr Chino Hills CA 91709 |
| Mailing Address |
1907 Boys Republic Dr Chino Hills CA 91709-5447 |
| Practice Telephone | 9096281217 |
| Practice Fax Number | 9093065427 |
| Mailing Telephone | 9096281217 |
| Mailing Fax Number | 9096279222 |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2019-06-27 |
| Authorized Official Name | MARIA AUSTIN (HEAD OF SERVICE) |
| Authorized Official Telephone | 9097030201 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043879208 | Boys Republic | Community/Behavioral Health | 1260 Monterey Pass Rd, Monterey Park, CA 91754-3617 | 2019-06-11 |
| 1962930859 | Boys Republic | Community/Behavioral Health | 128 E Palm Ave, Monrovia, CA 91016-5108 | 2017-05-23 |
| 1801346655 | Boys Republic | Community/Behavioral Health | 3850 Eucalyptus Ave, Chino Hills, CA 91709-1807 | 2016-10-05 |
| 1124585781 | Boys Republic | Community/Behavioral Health | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2019-03-01 |
| Street Address |
1907 BOYS REPUBLIC DR |
| City | CHINO HILLS |
| State | CA |
| Zip Code | 91709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053489567 | David John Palmer | Social Worker | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2006-12-01 |
| 1366050726 | Aaron-john Villon | Counselor | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2020-07-21 |
| 1083237358 | Taylor Shannon Quaranta | Marriage & Family Therapist | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2020-05-21 |
| 1427671916 | Brittney Lewis | Case Manager/Care Coordinator | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2020-05-19 |
| 1568084176 | Jocael Suarez | Case Manager/Care Coordinator | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2020-05-18 |
| 1528699808 | Monica Zamora | Case Manager/Care Coordinator | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2020-01-27 |
| 1437780780 | Kaiameka Brown | Case Manager/Care Coordinator | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2020-01-27 |
| 1699315457 | Auston Johnson | Case Manager/Care Coordinator | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2020-01-09 |
| 1073153813 | Cedric Julius | Case Manager/Care Coordinator | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2020-01-09 |
| 1780224576 | Joseph Raymond Mascarenaz | Case Manager/Care Coordinator | 1907 Boys Republic Dr, Chino Hills, CA 91709-5447 | 2020-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295384 | Jimmy Nguyen Dds Inc | Dentist | 13089 Peyton Dr. Ste. B, Chino Hills, CA 91709 | 2020-11-03 |
| 1811501166 | Carla Rita Rambo | Specialist/Technologist | 14772 Pineline Ave, Chino Hills, CA 91709 | 2020-09-03 |
| 1164071684 | Julia Grienitz | Physician Assistant | 3110 Chino Ave Ste 150b, Chino Hills, CA 91709 | 2019-09-06 |
| 1063992014 | Bonifacio Coronel Fontanilla | Respiratory Therapist, Certified | 2363 Scenic Ridge Dr, Chino Hills, CA 91709 | 2018-08-20 |
| 1174023832 | William George Kyriakakos | Counselor | 3782 Daisy Dr, Chino Hills, CA 91709 | 2018-02-19 |
| 1538677604 | Qurban Dental Corproation | Dentist | 15850 Soquel Canyon Pkwy, Suite A, Chino Hills, CA 91709 | 2018-01-11 |
| 1184131831 | Jacqueline Davidson | Specialist/Technologist | 14255 Peyton Dr., Chino Hills, CA 91709 | 2018-01-03 |
| 1508384702 | Jessica Suwan | Nurse Practitioner | 15403 Aqueduct Lane, Chino Hills, CA 91709 | 2017-09-07 |
| 1750809240 | Livewell Therapy, Inc. | Counselor | 5861 Pine Ave., Chino Hills, CA 91709 | 2017-09-05 |
| 1982122776 | Corey Robert Tiller | Physician Assistant | 1737 Walnut Creek Drive, Chino Hills, CA 91709 | 2017-09-01 |
| Find all providers in zip 91709 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538244 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 10525 Fuerte Dr, La Mesa, CA 91941-4350 | 2020-11-05 |
| 1154922458 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 24171 Grayston Dr, Lake Forest, CA 92630-3839 | 2020-11-03 |
| 1003417684 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 1155 Hoover St, Carlsbad, CA 92008-4230 | 2020-11-02 |
| 1497356075 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 405 N Tremont St, Oceanside, CA 92054-2535 | 2020-11-02 |
| 1467053041 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 6477 Goldenbush Dr, Carlsbad, CA 92011-4203 | 2020-11-02 |
| 1366043937 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 26065 Waterwheel Pl, Laguna Hills, CA 92653-6114 | 2020-11-02 |
| 1730780313 | Orchid Court, Inc. | Community Based Residential Treatment Facility, Mental Illness | 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325 | 2020-11-02 |
| 1477151199 | Inspiring Pathways, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1798 Bryman St, Hanford, CA 93230-7144 | 2020-10-14 |
| 1356949226 | Wings Recovery Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3134 Morningside Dr, Oceanside, CA 92056-4401 | 2020-10-13 |
| 1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
| City | CHINO HILLS |
| Zip Code | 91709 |
Please comment or provide details below to improve the information on BOYS REPUBLIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.