NPIMap

Organization Active NPI

Boys Republic

  • Mental Illness Community Based Residential Treatment Facility
  • Chino Hills, CA
National Provider Identifier
1801346655
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
3850 Eucalyptus Ave
Chino Hills, CA 91709-1807
Phone
(909) 597-9974
Fax
(909) 627-9222
NPI assigned
Oct 5, 2016
Last updated
Nov 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
BOYS REPUBLICAs reported in NPPES

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, LPCCNPI 1083998454
Title
Clinical Director
Phone
(909) 628-1217

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

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

Addresses

Primary practice location

3850 Eucalyptus Ave
Chino Hills, CA 91709-1807

Mailing address

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

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.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669766400000",
    "number": "1801346655",
    "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": "3850 EUCALYPTUS AVE",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091807",
            "telephone_number": "909-597-9974",
            "fax_number": "909-627-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS REPUBLIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOYS REPUBLIC",
        "enumeration_date": "2016-10-05",
        "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": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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.