Provider Demographics
NPI:1083017610
Name:RUSSELL NESBITT SERVICES INC
Entity Type:Organization
Organization Name:RUSSELL NESBITT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:CORPORATE CONTROLLER
Authorized Official - Phone:304-232-0233
Mailing Address - Street 1:431 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6529
Mailing Address - Country:US
Mailing Address - Phone:304-232-0233
Mailing Address - Fax:304-233-1777
Practice Address - Street 1:431 FULTON ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6529
Practice Address - Country:US
Practice Address - Phone:304-232-0233
Practice Address - Fax:304-233-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10347953385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care