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General NPI Number Information
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NPI Number | 1639339898
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Entity Type | Organization
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Legal Business Name | TOUCHSTONE WELLNESS INSTITUTE LLC
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 2650 BAHIA VISTA ST SUITE 106
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City | SARASOTA
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State | FL
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Zip | 34239-2635
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Country | US
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Telephone | 941-812-5321
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Fax |
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Provider Business Mailing Address
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Address Line | 2650 BAHIA VISTA ST SUITE 106
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City | SARASOTA
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State | FL
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Zip | 34239-2635
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Country | US
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Telephone | 941-812-5321
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. WALTER WADE BOTKIN III
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Credential | LMHC
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Telephone | 941-812-5321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH9485
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License Number State | FL
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