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Organization
PURPOSELY CHOSEN, INC.
Active
Organization
PURPOSELY CHOSEN, INC.
Active
Other names
Born for Nia Maternity Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DRETONA TENESE MADDOX RN (EXECUTIVE DIRECTOR)
(909) 471-0697
Entity
Organization
Contact information
Practice address
1410 3RD ST, SUITE 2, RIVERSIDE, CA 92507-3482
(909) 471-0697
(760) 302-7607
Mailing address
1410 3RD ST, SUITE 2, RIVERSIDE, CA 92507-3482
(909) 471-0697
(760) 302-7607
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/29/2016
Last updated
08/11/2021
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