# GLENDALE ADVANCED HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992311104
- **Authorized official:** JOSEPH FORTUNATO (OWNER)
- **Authorized official phone:** (317) 257-2225

## Contact information

- **Practice address:** 6321 N. KEYSTONE AVE, STE. B, INDIANAPOLIS, IN 46220
- **Practice address phone:** (317) 257-2225
- **Mailing address:** 6321 N KEYSTONE AVE, SUITE B, INDIANAPOLIS, IN 46220-2156
- **Mailing address phone:** (317) 257-2225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/22/2020
- **Last updated:** 09/23/2021