Organization
SELAH WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA KELLER (VP COMPLIANCE)
(320) 372-2323
Entity
Organization
Contact information
Practice address
905 FOREST AVE E STE 150, MORA, MN 55051-1632
(320) 372-2323
(833) 651-2526
Mailing address
501 MAIN ST, SANDSTONE, MN 55072-4410
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/20/2026
Last updated
02/18/2026
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