# POLARIS MENTAL HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992513196
- **Authorized official:** GARRY DALE (OFFICE MANAGER)
- **Authorized official phone:** (617) 316-6776

## Contact information

- **Practice address:** 10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517
- **Practice address phone:** (571) 229-8708
- **Mailing address:** 10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/20/2024
- **Last updated:** 12/20/2024