Organization
LOYAL LIVING LLC.
Active
Organization
LOYAL LIVING LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SHELTON (PROGRAM MANAGER)
(214) 900-8360
Entity
Organization
Contact information
Practice address
3504 MT VERNON AVE, FORT WORTH, TX 76103-2527
(214) 900-8360
Mailing address
PO BOX 181698, ARLINGTON, TX 76096-1698
(214) 900-8360
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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