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General NPI Number Information
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NPI Number | 1518185495
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Entity Type | Organization
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Legal Business Name | SELECTIVE NURSING, LLC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 04/04/2019
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Provider Practice Location Address
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Address Line | 2107 JERGENS RD
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City | DAYTON
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State | OH
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Zip | 45404-1227
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Country | US
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Telephone | 937-260-4250
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Fax | 937-260-4250
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Provider Business Mailing Address
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Address Line | 2107 JERGENS RD
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City | DAYTON
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State | OH
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Zip | 45404-1227
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Country | US
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Telephone | 937-260-4250
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Fax | 937-260-4250
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Authorized Official
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Title or Position | MANAGER
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Name | RHONDA L DEBORD
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Credential | LPN
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Telephone | 937-902-7325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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