Provider Demographics
NPI:1043070840
Name:SELECT CARE SERVICES
Entity Type:Organization
Organization Name:SELECT CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:CHARMAINE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:810-835-2030
Mailing Address - Street 1:5335 NOTTINGHAM DR N
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2851
Mailing Address - Country:US
Mailing Address - Phone:810-835-2030
Mailing Address - Fax:
Practice Address - Street 1:5335 NOTTINGHAM DR N
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2851
Practice Address - Country:US
Practice Address - Phone:810-835-2030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care