Provider Demographics
NPI:1083383129
Name:SELAH HOUSE, LLC
Entity Type:Organization
Organization Name:SELAH HOUSE, LLC
Other - Org Name:ASTER SPRINGS JEFFERSONVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SARNACKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-864-8145
Mailing Address - Street 1:4500 TOWN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-7148
Mailing Address - Country:US
Mailing Address - Phone:812-389-8685
Mailing Address - Fax:812-315-3250
Practice Address - Street 1:4500 TOWN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-7148
Practice Address - Country:US
Practice Address - Phone:812-389-8685
Practice Address - Fax:812-315-3250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-11
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)