Healthcare Provider Details

I. General information

NPI: 1740775428
Provider Name (Legal Business Name): SELMA CARE HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 STILLMAN ST
SELMA CA
93662-3026
US

IV. Provider business mailing address

PO BOX 8049
VISALIA CA
93290-8049
US

V. Phone/Fax

Practice location:
  • Phone: 559-896-4990
  • Fax: 559-834-2353
Mailing address:
  • Phone: 559-901-3147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BRANDON DAVID BIGELOW
Title or Position: PRESIDENT/CEO
Credential:
Phone: 559-901-3147