| NPI | 1346514262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES POLK President/Director 877-879-7655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810001848) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904007185) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2012-02-24 |