Provider Demographics
NPI:1093420036
Name:NELLA HEALTH REHABILITATION LLC
Entity Type:Organization
Organization Name:NELLA HEALTH REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACKSON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCNEAL
Authorized Official - Suffix:II
Authorized Official - Credentials:PT, OCS, FAAOMPT
Authorized Official - Phone:337-246-0220
Mailing Address - Street 1:1007 SUSAN CT
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-4484
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1007 SUSAN CT
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-4484
Practice Address - Country:US
Practice Address - Phone:337-246-0220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy