Organization · Type 2 NPI

Boys Republic

Mental Illness Community Based Residential Treatment Facility · Pomona, CA

NPI number 1215489000 Active

Practice location

733 N Garey Ave
Pomona, CA 91767

Call (909) 622-3556 Map

Fax (909) 306-5427

Mailing address

1907 Boys Republic Dr
Chino Hills, CA 91709-5447

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency	251S00000X	None listed
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	None listed

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

2 other providers at this address

Other mental illness community based residential treatment facility providers in Pomona

St. Joseph-Christopher Aquinas Detox CenterMental Illness Community Based Residential Treatment Facility Pomona, CA NPI 1427427269

See all in Pomona →

NPI record

NPI: 1215489000
Entity type: Organization (Type 2)
Issued: Oct 27, 2016
Last updated: Nov 30, 2022
Status: Active
Subpart: Yes of Boys Republic

Other names

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Boys Republic - Pomona Residence · other name

Authorized official

Bayley Dark, LCSW
Clinician/head of Service
(909) 536-6611

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1215489000

Boys Republic's National Provider Identifier is 1215489000, issued on Oct 27, 2016. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Pomona, CA. The record was last updated on Nov 30, 2022.