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Individual

MS. SHALITHA SHELBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3917 ORLANDO SPRINGS DR, FORT WORTH, TX 76123-1485
(817) 729-1150
Mailing address
PO BOX 1334, FORT WORTH, TX 76101-1334
(817) 729-1150

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
172V00000X
Community Health Worker
251S00000X
Community/Behavioral Health Agency
311ZA0620X
Adult Care Home Facility
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320800000X
Mental Illness Community Based Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle
385H00000X
Respite Care
385HR2050X
Respite Care Camp
TX
385HR2050X
Respite Care Camp
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
12/29/2010
Last updated
10/12/2012
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