| NPI | 1962930859 |
|---|---|
| Other Name | BOYS REPUBLIC - MONROVIA |
| Entity Type | Organization |
| Authorized Contact | ELLEN STRICKLAND Residence Clinical Supervisor 909-287-6433 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2022-11-30 |