Organization
CENTER FOR RESTORATIVE PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCUS H SMALL LMFT (EXECUTIVE DIRECTOR)
(707) 322-4971
Entity
Organization
Contact information
Practice address
639 DRAKE AVE., MARIN CITY, CA 94965
(707) 322-4971
Mailing address
PO BOX 1435, SAUSALITO, CA 94966-1435
(707) 322-4971
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
39843305
CA
Other
Enumeration date
01/26/2007
Last updated
08/13/2020
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