Organization
PURPOSELY CHOSEN, INC.
Active
Parent organization
PURPOSELY CHOSEN, INC.
Other names
Born for Nia Maternity Home - San Bernardino
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
2248 SHERIDAN RD, SAN BERNARDINO, CA 92407-2444
(909) 473-1700
(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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