Provider Demographics
NPI:1740775428
Name:SELMA CARE HOLDINGS, LLC
Entity Type:Organization
Organization Name:SELMA CARE HOLDINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BIGELOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-901-3147
Mailing Address - Street 1:PO BOX 8049
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-8049
Mailing Address - Country:US
Mailing Address - Phone:559-901-3147
Mailing Address - Fax:
Practice Address - Street 1:2108 STILLMAN ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-3026
Practice Address - Country:US
Practice Address - Phone:559-896-4990
Practice Address - Fax:559-834-2353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility