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General NPI Number Information
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NPI Number | 1720734247
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Entity Type | Organization
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Legal Business Name | SELAH HEALTH
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 05/11/2024
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Provider Practice Location Address
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Address Line | 180 S THORNTON AVE
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City | PIGGOTT
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State | AR
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Zip | 72454-2731
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Country | US
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Telephone | 870-970-3180
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Fax | 870-343-6262
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Provider Business Mailing Address
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Address Line | PO BOX 301
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City | PIGGOTT
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State | AR
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Zip | 72454-0301
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Country | US
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Telephone | 870-970-3180
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Fax | 870-201-9686
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Authorized Official
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Title or Position | CEO
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Name | AMANDA GAIL SMALLMON
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Credential | APRN
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Telephone | 870-970-3180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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