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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