Healthcare Provider Details

I. General information

NPI: 1245171263
Provider Name (Legal Business Name): SELAH HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 PARK MEADOW LN APT J
ELYRIA OH
44035-7327
US

IV. Provider business mailing address

203 PARK MEADOW LN APT J
ELYRIA OH
44035-7327
US

V. Phone/Fax

Practice location:
  • Phone: 469-735-9833
  • Fax: 469-735-9833
Mailing address:
  • Phone: 469-735-9833
  • Fax: 469-735-9833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JANA CAPRICE EDWARDS
Title or Position: CAREGIVER
Credential: CAREGIVER
Phone: 469-735-9833