Organization
MOUNTAIN RIVER THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLEY SRIKANTAIAH LCSW (OWNER)
(541) 516-0124
Entity
Organization
Contact information
Practice address
223 SE DAVIS AVE, BEND, OR 97702-3526
(480) 307-2713
Mailing address
70 SW CENTURY DR. STE 100 PMB 5099, BEND, OR 97702-3558
(541) 516-0124
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/11/2019
Last updated
08/05/2023
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