Organization
DIVERSICARE OF SELMA, LLC
Active
Parent organization
DIVERSICARE HOLDING COMPANY, LLC
Other names
Park Place
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVERSICARE HOLDING COMPANY, LLC
Authorized official
MATTHEW J WEISHAAR (CHIEF FINANCIAL OFFICER)
(615) 550-9459
Entity
Organization
Contact information
Practice address
100 PARK PL, SELMA, AL 36701
(334) 872-3471
(334) 872-8923
Mailing address
1621 GALLERIA BLVD, BRENTWOOD, TN 37027-2926
(615) 550-9453
(615) 915-6935
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N2402
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206565
—
AL
Enumeration date
03/20/2017
Last updated
04/07/2023
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