Organization
LOYAL SOURCE WORLDWIDE, INC.
Active
Other names
Loyal Cares
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA LELLO LMHC (BEHAVIORAL HEALTH CLINIC DIRECTOR)
(407) 707-9781
Entity
Organization
Contact information
Practice address
12612 CHALLENGER PKWY STE 365, ORLANDO, FL 32826-2784
(407) 707-9781
(234) 241-2258
Mailing address
12612 CHALLENGER PKWY STE 365, ORLANDO, FL 32826-2784
(407) 707-9781
(234) 241-2258
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/25/2021
Last updated
04/19/2021
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