Basic Information
| Provider Information | |||||||||
| NPI: | 1740775428 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SELMA CARE HOLDINGS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8049 | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932908049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5599013147 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2108 STILLMAN ST | ||||||||
| Address2: | |||||||||
| City: | SELMA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936623026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5598964990 | ||||||||
| FaxNumber: | 5598342353 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2018 | ||||||||
| LastUpdateDate: | 06/26/2018 | ||||||||
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| AuthorizedOfficialLastName: | BIGELOW | ||||||||
| AuthorizedOfficialFirstName: | BRANDON | ||||||||
| AuthorizedOfficialMiddleName: | DAVID | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 5599013147 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.