BOYS REPUBLIC – NPI #1215489000
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

BOYS REPUBLIC is a community based residential treatment facility located in POMONA, CA. NPPES has assigned the NPI number 1215489000 to BOYS REPUBLIC on October 27, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. BOYS REPUBLIC is also known by the name BOYS REPUBLIC - POMONA RESIDENCE. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

The NPI profile was previously updated about 4 years ago on Nov 30, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BOYS REPUBLIC below.

NPI Profile for
BOYS REPUBLIC

NPI Number
1215489000
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BOYS REPUBLIC
Other Name: BOYS REPUBLIC - POMONA RESIDENCE
Primary location
733 N GAREY AVE
POMONA, CA 91767
Phone: (909) 622-3556 Fax: (909) 306-5427
Mailing address
1907 BOYS REPUBLIC DR
CHINO HILLS, CA 91709-5447
Phone: (909) 628-1217 Fax: (909) 627-9222
Organization Subpart
Yes - BOYS REPUBLIC is subpart of another organization.
Authorized Official
BAYLEY DARK
CLINICIAN/HEAD OF SERVICE
Phone: (909) 536-6611
Updated
Certification Date
Nov 30, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)
251S00000X
- Community/Behavioral Health

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.