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General NPI Number Information
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NPI Number | 1588531370
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Entity Type | Organization
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Legal Business Name | RUACH RENEWAL THERAPY CENTER PLLC
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 2833 NW 91ST AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5066
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Country | US
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Telephone | 954-856-0054
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Fax |
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Provider Business Mailing Address
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Address Line | 2833 NW 91ST AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5066
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Country | US
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Telephone | 954-856-0054
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELINE M MCINTOSH
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Credential | LMHC
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Telephone | 954-856-0054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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