Provider Demographics
NPI:1295993657
Name:SELAH HOSPICE CARE, INC.
Entity type:Organization
Organization Name:SELAH HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DULCE
Authorized Official - Middle Name:CORONA
Authorized Official - Last Name:CONDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-803-0895
Mailing Address - Street 1:PO BOX 4034
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4034
Mailing Address - Country:US
Mailing Address - Phone:956-803-0895
Mailing Address - Fax:800-517-4764
Practice Address - Street 1:1101 E DALLAS AVE UNIT 6
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8821
Practice Address - Country:US
Practice Address - Phone:956-803-0895
Practice Address - Fax:800-517-4764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-01
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001018135Medicaid
TX001018135Medicaid