Organization
POLK YOUTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID JAMES VALENCIA MS (EXECUTIVE DIRECTOR/PRESIDENT)
(503) 623-3310
Entity
Organization
Contact information
Practice address
175 NE KINGS VALLEY HWY STE A, DALLAS, OR 97338-1787
(503) 623-3310
Mailing address
175 NE KINGS VALLEY HWY STE A, DALLAS, OR 97338-1787
(503) 623-3310
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
0243
OR
Other
Enumeration date
01/14/2016
Last updated
01/14/2016
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