# PURPOSELY CHOSEN, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PURPOSELY CHOSEN, INC.
- **Other names:** Born for Nia Maternity Home - San Bernardino
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902401623
- **Legal business name:** PURPOSELY CHOSEN, INC.
- **Authorized official:** DRETONA TENESE MADDOX RN, PHN, LCSW (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (909) 471-0697

## Contact information

- **Practice address:** 2248 SHERIDAN RD, SAN BERNARDINO, CA 92407-2444
- **Practice address phone:** (909) 473-1700
- **Practice address fax:** (760) 302-7607
- **Mailing address:** 1410 3RD ST STE 2, RIVERSIDE, CA 92507-3454
- **Mailing address phone:** (909) 471-0697
- **Mailing address fax:** (760) 302-7607

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 12/01/2020
- **Last updated:** 12/01/2020