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General NPI Number Information
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NPI Number | 1427507235
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Entity Type | Organization
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Legal Business Name | SELAH ADULT CARE CORPORATION
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 133 FOURTH STREET
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City | BELVIDERE
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State | NJ
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Zip | 07823
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Country | US
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Telephone | 908-797-7193
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Fax | 877-627-7787
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Provider Business Mailing Address
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Address Line | 133 FOURTH STREET
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City | BELVIDERE
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State | NJ
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Zip | 07823
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Country | US
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Telephone | 908-797-7193
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Fax | 877-627-7787
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MRS. DARLENE TRANQUILLI
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Credential | CDP, CDCM, CADDCT
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Telephone | 908-797-7193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | D35026
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | D35026
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License Number State | NJ
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