Organization
RESILIENCE RENEWED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUSHAWN WRIGHT (DIRECTOR)
(469) 616-1969
Entity
Organization
Contact information
Practice address
2200 EVANS AVE STE 12, FORT WORTH, TX 76104-6066
(469) 616-1969
Mailing address
539 W COMMERCE ST STE 2241, DALLAS, TX 75208-1953
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management 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
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
01/04/2025
Last updated
05/06/2025
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