Organization
SELS SENIOR EXERCISE LIFESTYLE SERVICES
Active
Other names
SELS Inc
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA SWAMI CES (PRESIDENT)
(651) 208-4564
Entity
Organization
Contact information
Practice address
5950 CHURCHILL ST, SHOREVIEW, MN 55126-8427
(651) 208-4564
(651) 774-2107
Mailing address
1044 CENTERVILLE CIR, SUITE 200, VADNAIS HEIGHTS, MN 55127-6346
(651) 774-2107
(651) 774-1098
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
C10380
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
764117600
MHCP
MN
Enumeration date
11/22/2006
Last updated
06/16/2008
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