Organization · Type 2 NPI

Purposely Chosen, Inc.

Emotionally Disturbed Childrens' Residential Treatment Facility · San Bernardino, CA

NPI number 1902401623 Active

Practice location

2248 Sheridan Rd
San Bernardino, CA 92407-2444

Call (909) 473-1700 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.

Another provider at this address

Narishia LayeCounselor San Bernardino, CA NPI 1821992397

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NPI record

NPI: 1902401623
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 - San Bernardino · doing business as

Authorized official

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

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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 1902401623

Purposely Chosen, Inc.'s National Provider Identifier is 1902401623, issued on Dec 1, 2020. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in San Bernardino, CA. The record was last updated on Dec 1, 2020.