Healthcare Provider Details

I. General information

NPI: 1760843189
Provider Name (Legal Business Name): SELDRIA ASSISTED LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2016
Last Update Date: 03/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 E BARDIN RD 182232
ARLINGTON TX
76096-4201
US

IV. Provider business mailing address

PO BOX 182232
ARLINGTON TX
76096-2232
US

V. Phone/Fax

Practice location:
  • Phone: 682-465-7465
  • Fax: 801-720-4753
Mailing address:
  • Phone: 682-465-7465
  • Fax: 801-720-4753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateTX

VIII. Authorized Official

Name: REBECCA S WOODEN
Title or Position: GENERAL MANAGER
Credential:
Phone: 682-465-7465