Provider Demographics
NPI:1447674445
Name:SELAH PARTNERS, LLC
Entity type:Organization
Organization Name:SELAH PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RAYHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:217-826-6100
Mailing Address - Street 1:121 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:IL
Mailing Address - Zip Code:62441-1260
Mailing Address - Country:US
Mailing Address - Phone:217-826-6100
Mailing Address - Fax:217-826-6100
Practice Address - Street 1:121 N 6TH ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:IL
Practice Address - Zip Code:62441-1260
Practice Address - Country:US
Practice Address - Phone:217-826-6100
Practice Address - Fax:217-826-6100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008669251S00000X
IL149016176251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health