Sels Senior Exercise Lifestyle Services

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

C10380 Issued in MN

Legal business name

SELS SENIOR EXERCISE LIFESTYLE SERVICES

Practice address

5950 Churchill St
Shoreview, MN 55126-8427

Phone

(651) 208-4564

Fax

(651) 774-2107

NPI assigned

Nov 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandra Swami, CES

Title

President

Phone

(651) 208-4564

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SELS Inc Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1033284146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 CENTERVILLE CIR",
            "address_2": "SUITE 200",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551276346",
            "telephone_number": "651-774-2107",
            "fax_number": "651-774-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 CHURCHILL ST",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268427",
            "telephone_number": "651-208-4564",
            "fax_number": "651-774-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELS SENIOR EXERCISE LIFESTYLE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "SWAMI",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-208-4564",
        "authorized_official_credential": "CES"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MN",
            "license": "C10380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHCP",
            "identifier": "764117600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SELS Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jean Schumacher, NP-C
• Sheila Ann Schuster, LPCC
• Majken Anne Schwartz, MD
• Michele Marie Seifert, OT
• Courtney Ruth Sellberg, LPCC
• Sharon Stein McNamara Ed D Psychology Inc
• Ilyas Hashim Sheikh
• Sheila Conlin Ma, LP LMFT
• Kari Sherburne, CCC-SLP
• Donald Shope Jr., LADC, CAP

• Exclusive Provider Organization in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Exclusive Provider Organization in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.