NPIMap

Organization Active NPI

Boys Republic

  • Mental Illness Community Based Residential Treatment Facility
  • Chino Hills, CA
National Provider Identifier
1124585781
Registry record updated Nov 30, 2022
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
1907 Boys Republic Dr
Chino Hills, CA 91709-5447
Phone
(909) 628-1217
Fax
(909) 306-5427
NPI assigned
Mar 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Authorized official

Name
Federico Escobedo Jarque, LMFT, LPCC
Title
Clinical Director
Phone
(909) 628-1217

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

1907 Boys Republic Dr
Chino Hills, CA 91709-5447

Mailing address

1907 Boys Republic Dr
Chino Hills, CA 91709-5447

National Provider Directory

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

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669766400000",
    "number": "1124585781",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 BOYS REPUBLIC DR",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095447",
            "telephone_number": "909-628-1217",
            "fax_number": "909-306-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS REPUBLIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-01",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A",
        "authorized_official_last_name": "ESCOBEDO JARQUE",
        "authorized_official_first_name": "FEDERICO",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "909-628-1217",
        "authorized_official_credential": "LMFT, LPCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.