Organization · Type 2 NPI

Purposely Chosen, Inc.

Emotionally Disturbed Childrens' Residential Treatment Facility · Moreno Valley, CA

NPI number 1679178396 Active

Practice location

25030 Ocotillo Ave
Moreno Valley, CA 92553-4440

Call (951) 247-3000 Map

Fax (760) 302-7607

Mailing address

1410 3rd St Ste 2
Riverside, CA 92507-3454

Specialties and licenses

Taxonomy	Code	License
Emotionally Disturbed Childrens' Residential Treatment Facility Primary	322D00000X	None listed

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

4 other providers at this address

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NPI record

NPI: 1679178396
Entity type: Organization (Type 2)
Issued: Dec 1, 2020
Last updated: Dec 1, 2020
Status: Active
Subpart: Yes of Purposely Chosen, Inc.

Other names

Born for Nia Maternity Home - Moreno Valley · doing business as

Authorized official

Dretona Tenese Maddox, RN, PHN, LCSW
Executive Director
(909) 471-0697

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About NPI 1679178396

Purposely Chosen, Inc.'s National Provider Identifier is 1679178396, issued on Dec 1, 2020. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Moreno Valley, CA. The record was last updated on Dec 1, 2020.