Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Substance Abuse Disorder Rehabilitation Facility |
324500000X | |||
Substance Abuse Treatment, Children |
3245S0500X |
| NPI Number | 1619774783 |
| LBN Legal business name | SELAH WELLNESS CENTER LLC |
| Authorized official | NAOMI KOENIG - (CEO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 02/26/2025 |
| Last updated | 03/03/2025 - More than a year ago |
| Identifiers | n/a |
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SELAH WELLNESS CENTER LLC
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