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BOYS REPUBLIC - GRAVES STRTP
NPI 1356032817
Community Based Residential Treatment Facility, Mental Illness in Chino Hills, CA

Active since May 16, 2023
3606 JOHN WATKINS WAY, CHINO HILLS, CA 91709(909) 740-3136(909) 306-5427 Get Directions Write a Review

NPPES record last updated: December 29, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Boys Republic - Graves Strtp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOYS REPUBLIC - GRAVES STRTP (NPI 1356032817) is a healthcare organization registered as a community based residential treatment facility, mental illness in Chino Hills, California and active in the NPI registry since May 2023. The organization lists Michael Roa, Clinical Supervisor/head Of Service, as its authorized official.

NPPES Registry Identity

NPI1356032817
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameBOYS REPUBLIC
Location Address3606 JOHN WATKINS WAYChino Hills, CA 91709-5453
Mailing Address1907 Boys Republic DrChino Hills, CA 91709-5447 · (909) 628-1217 · Fax (909) 306-5427
Phone(909) 740-3136
Fax(909) 306-5427
Organization SubpartYes
Authorized OfficialMichael RoaClinical Supervisor/head Of Service · (909) 925-8134
Enumeration DateMay 16, 2023
Last NPPES UpdateDecember 29, 2023
NPPES CertifiedDecember 29, 2023
✔ NPI 1356032817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
3606 JOHN WATKINS WAY, Chino Hills, CA 91709
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Other Names 1

Other NameBoys Republic - Graves Strtp

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIA RYAN SMITH
Day Training/Habilitation Specialist
3606 JOHN WATKINS WAY
CHINO HILLS, CA 91709
San Bernardino County (909) 974-3136
JIMMY PINEDA
Social Worker (Clinical)
3606 JOHN WATKINS WAY
CHINO HILLS, CA 91709
San Bernardino County (909) 740-3136
STEPHANIE ALEXANDRA SALAS
Case Manager/Care Coordinator
3606 JOHN WATKINS WAY
CHINO HILLS, CA 91709
San Bernardino County (909) 740-3136
YASI KHALADJZADEH
Social Worker (Clinical)
3606 JOHN WATKINS WAY
CHINO HILLS, CA 91709
San Bernardino County (909) 740-3136

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boys Republic's NPI number?

The NPI number for Boys Republic is 1356032817. It was assigned to this organization in the NPPES registry on May 16, 2023. The provider is also known as Boys Republic - Graves Strtp.

Where is Boys Republic located?

Boys Republic is located at 3606 John Watkins Way, Chino Hills, CA 91709. The listed phone number is (909) 740-3136.

What is Boys Republic's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Boys Republic was last updated on December 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.