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1609137314
DANIEL A POLSTON
GRASS VALLEY, CA
NPI
1609137314
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
322D00000X Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
2012-05-30
Last Update Date
2012-05-30
Business Address
-- DANIEL A POLSTON
714 W MAIN ST
GRASS VALLEY, CA 95945-6410
Phone number: 530-477-9800
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Mailing Address
-- DANIEL A POLSTON
714 W MAIN ST
GRASS VALLEY, CA 95945-6410
Phone number: 530-477-9800
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