Organization
THERAPY WITHOUT WALLS RENEWED LLC
Active
Organization
THERAPY WITHOUT WALLS RENEWED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAJUANA DENISE RUSHIN MA (CLINICAL DIRECTOR)
(407) 929-9019
Entity
Organization
Contact information
Practice address
1303 N PINE HILLS RD, ORLANDO, FL 32808-4816
(407) 929-9019
(321) 445-4710
Mailing address
PO BOX 608896, ORLANDO, FL 32860-8896
(407) 929-9019
(321) 445-4710
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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