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Organization

CHILD THERAPY INSTITUTE OF MARIN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN LUKAS (EXECUTIVE DIRECTOR)
(415) 456-7727
Entity
Organization

Contact information

Practice address
2926 LONE TREE WAY, ANTIOCH, CA 94509-4924
(925) 301-7587
Mailing address
1480 LINCOLN AVE STE 8, SAN RAFAEL, CA 94901-2085
(415) 456-7724
(415) 456-1050

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
11/07/2007
Last updated
11/07/2007
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