Organization
MARY'S RIVER COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLAUS GOEBELER (MANAGER)
(541) 708-0937
Entity
Organization
Contact information
Practice address
2364 MAIN ST, BLDG A, PHILOMATH, OR 97370-9488
(541) 708-0937
Mailing address
2364 MAIN ST, BLDG A, PHILOMATH, OR 97370-9488
(541) 708-0937
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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