Provider Demographics
NPI:1184484149
Name:SELENE HEALTHCARE STAFFING AND HOME CARE
Entity type:Organization
Organization Name:SELENE HEALTHCARE STAFFING AND HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALANA
Authorized Official - Middle Name:MARIEL
Authorized Official - Last Name:TIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-373-6029
Mailing Address - Street 1:4620 CHARLIE CADE RD
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:SC
Mailing Address - Zip Code:29541-7733
Mailing Address - Country:US
Mailing Address - Phone:843-373-6029
Mailing Address - Fax:
Practice Address - Street 1:4620 CHARLIE CADE RD
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:SC
Practice Address - Zip Code:29541-7733
Practice Address - Country:US
Practice Address - Phone:843-373-6029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No385H00000XRespite Care FacilityRespite Care