Provider Demographics
NPI:1205100393
Name:PSYCHOLOGICAL RESOURCE CENTERS, INC.
Entity type:Organization
Organization Name:PSYCHOLOGICAL RESOURCE CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:BLOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:760-322-5191
Mailing Address - Street 1:2150 E TAHQUITZ CANYON WAY
Mailing Address - Street 2:SUITE 10
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-7045
Mailing Address - Country:US
Mailing Address - Phone:760-322-5191
Mailing Address - Fax:760-778-6984
Practice Address - Street 1:2150 E TAHQUITZ CANYON WAY
Practice Address - Street 2:SUITE 10
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7045
Practice Address - Country:US
Practice Address - Phone:760-322-5191
Practice Address - Fax:760-778-6984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8495103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty