Provider Demographics
NPI:1760843189
Name:SELDRIA ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:SELDRIA ASSISTED LIVING, LLC
Other - Org Name:SELDRIA ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WOODEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-465-7465
Mailing Address - Street 1:PO BOX 182232
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76096-2232
Mailing Address - Country:US
Mailing Address - Phone:682-465-7465
Mailing Address - Fax:801-720-4753
Practice Address - Street 1:1301 E BARDIN RD
Practice Address - Street 2:182232
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76096-4201
Practice Address - Country:US
Practice Address - Phone:682-465-7465
Practice Address - Fax:801-720-4753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-12
Last Update Date:2016-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home