| Boys Republic | |
|
3850 Eucalyptus Ave Chino Hills CA 91709-1807 | |
| (909) 597-9974 | |
| (909) 627-9222 |
| Full Name | Boys Republic |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 3850 Eucalyptus Ave, Chino Hills, California |
| Authorized Official Name and Position | Federico Escobedo Jarque (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9096281217 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boys Republic 1907 Boys Republic Dr Chino Hills CA 91709-5447 Ph: (909) 628-1217 | Boys Republic 3850 Eucalyptus Ave Chino Hills CA 91709-1807 Ph: (909) 597-9974 |
| NPI Number | 1801346655 |
|---|---|
| Provider Enumeration Date | 10/05/2016 |
| Last Update Date | 11/30/2022 |
| Certification Date | 11/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801346655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Primary |
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