Organization
FORMATION COUNSELING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTY GOEHRING PH.D. (PRESIDENT)
(505) 821-3628
Entity
Organization
Contact information
Practice address
8600 ACADEMY RD NE, ALBUQUERQUE, NM 87111-1107
(505) 821-3628
(505) 856-7103
Mailing address
8600 ACADEMY RD NE, ALBUQUERQUE, NM 87111-1107
(505) 821-3628
(505) 856-7103
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/26/2006
Last updated
03/19/2019
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