NPIMap

Organization Active NPI

Boys Republic

  • Mental Illness Community Based Residential Treatment Facility
  • Monrovia, CA
National Provider Identifier
1023560836
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
BOYS REPUBLIC
Practice address
802 Ocean View Ave
Monrovia, CA 91016-2420
Phone
(909) 628-1217
NPI assigned
Oct 27, 2016
Organization subpart
Yes
Parent organization
BOYS REPUBLICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Authorized official

Name
Whitney Paine, LCSW
Title
Clinician/Head of Service
Phone
(909) 993-2658

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

802 Ocean View Ave
Monrovia, CA 91016-2420

Mailing address

1907 Boys Republic Dr
Chino Hills, CA 91709-5447
Phone (909) 628-1217

Other names 1

  • Boys Republic - Monrovia Residence Other name

National Provider Directory

National Provider Directory
Tax ID family
Boys Republic11 organizations share this tax ID, including this one
Part of
Boys Republic

Other organizations with this tax ID 10

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

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/boysrepublic/r4/

NPI Registry JSON

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1023560836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 BOYS REPUBLIC DR",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095447",
            "telephone_number": "909-628-1217",
            "fax_number": "909-627-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 OCEAN VIEW AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910162420",
            "telephone_number": "909-628-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS REPUBLIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOYS REPUBLIC",
        "enumeration_date": "2016-10-27",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "PAINE",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "CLINICIAN/HEAD OF SERVICE",
        "authorized_official_telephone_number": "909-993-2658",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boys Republic - Monrovia Residence",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monrovia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.