Healthcare Provider Details

I. General information

NPI: 1033838768
Provider Name (Legal Business Name): SELECT NURSING CO LIMITED LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 MARJORIE RD
SNELLVILLE GA
30039-6538
US

IV. Provider business mailing address

4315 MARJORIE RD
SNELLVILLE GA
30039-6538
US

V. Phone/Fax

Practice location:
  • Phone: 678-599-4051
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: KEEGAN ALEXANDER
Title or Position: CEO
Credential: LPN
Phone: 404-441-2394