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Organization

THE ABILITY TO ACHIEVE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHALITHA SHELBY (PROGRAM DIRECTOR)
(817) 729-1150
Entity
Organization

Contact information

Practice address
1516 E MAGNOLIA AVE, FORT WORTH, TX 76104-5623
(817) 729-1150
Mailing address
PO BOX 1334, FORT WORTH, TX 76101-1334
(817) 729-1150

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251C00000X
Developmentally Disabled Services Day Training Agency
251S00000X
Community/Behavioral Health Agency
251V00000X
Voluntary or Charitable Agency
253Z00000X
In Home Supportive Care Agency
302F00000X
Exclusive Provider Organization
Primary
320800000X
Mental Illness Community Based Residential Treatment Facility
347C00000X
Private Vehicle
385HR2050X
Respite Care Camp

Other

Enumeration date
11/28/2012
Last updated
11/28/2012
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