| NPI | 1760619514 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MICHAEL WILLIAM LADWIG President 386-506-9381  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH#00874)  | 
| Enumeration Date | 2009-06-19 | 
| Last Update Date | 2009-06-19 |