Organization
VA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE MARNELL (DIRECTOR)
(541) 440-1000
Entity
Organization
Contact information
Practice address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97470-6513
(541) 440-1000
(541) 440-1273
Mailing address
1281 SE MAGNOLIA DR., ROSEBURG, OR 97470-6513
(541) 440-1000
(541) 440-1273
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/23/2006
Last updated
07/21/2022
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