Healthcare Provider Details

I. General information

NPI: 1912317876
Provider Name (Legal Business Name): HOUSE OF SHILOH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3604 S COOPER ST STE 110
ARLINGTON TX
76015-3482
US

IV. Provider business mailing address

3604 S COOPER ST STE 110
ARLINGTON TX
76015-3482
US

V. Phone/Fax

Practice location:
  • Phone: 682-246-2669
  • Fax:
Mailing address:
  • Phone: 817-729-7577
  • Fax: 888-517-4445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number66572
License Number StateTX

VIII. Authorized Official

Name: VIOLET NWOKOYE
Title or Position: DIRECTOR
Credential: LPC, JD
Phone: 817-729-7577