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Organization

BOYS REPUBLIC

Active
Parent organization
BOYS REPUBLIC
Other names
Boys Republic - Monrovia Residence
Organization subpart
Yes

Provider details

NPI number
Legal business name
BOYS REPUBLIC
Authorized official
WHITNEY PAINE LCSW (CLINICIAN/HEAD OF SERVICE)
(909) 993-2658
Entity
Organization

Contact information

Practice address
802 OCEAN VIEW AVE, MONROVIA, CA 91016-2420
(909) 628-1217
Mailing address
1907 BOYS REPUBLIC DR, CHINO HILLS, CA 91709-5447
(909) 628-1217
(909) 627-9222

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
10/27/2016
Last updated
12/29/2023
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