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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