Organization
NELLAS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS R. EIDELL SR. (ADMINISTRATOR/PRESIDENT)
(304) 636-1008
Entity
Organization
Contact information
Practice address
FERGUSON ROAD, BLDG 1, ELKINS, WV 26241-1639
(304) 636-1008
(304) 637-6106
Mailing address
PO BOX 1639, FERGUSON ROAD, BLDG 1, ELKINS, WV 26241-1639
(304) 636-1008
(304) 637-6106
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
51
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003795000
—
WV
Enumeration date
06/30/2005
Last updated
08/22/2020
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