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Organization

PURPOSELY CHOSEN, INC.

Active
Parent organization
PURPOSELY CHOSEN, INC.
Other names
Born for Nia Maternity Home - Moreno Valley
Organization subpart
Yes

Provider details

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

Contact information

Practice address
25030 OCOTILLO AVE, MORENO VALLEY, CA 92553-4440
(951) 247-3000
(760) 302-7607
Mailing address
1410 3RD ST STE 2, RIVERSIDE, CA 92507-3454
(909) 471-0697
(760) 302-7607

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary

Other

Enumeration date
12/01/2020
Last updated
12/01/2020
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