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Organization
RESTORATION THERAPY CENTER OF SD, A MFT CORP
Active
Organization
RESTORATION THERAPY CENTER OF SD, A MFT CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELVIN LANCE AHL M.S., M.DIV. (PRESIDENT)
(714) 222-0331
Entity
Organization
Contact information
Practice address
5650 EL CAMINO REAL, STE 130, CARLSBAD, CA 92008-7124
(714) 222-0331
Mailing address
5650 EL CAMINO REAL, STE 130, CARLSBAD, CA 92008-7124
(714) 222-0331
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
#86028
CA
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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