Organization
MEDELLA HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY TUTT NURSE PRACTITIONER (PRESIDENT)
(502) 235-5437
Entity
Organization
Contact information
Practice address
321 RIDGE RD, CHARLESTOWN, IN 47111-2033
(502) 235-5437
Mailing address
321 RIDGE RD, CHARLESTOWN, IN 47111-2033
(502) 235-5437
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/23/2022
Last updated
10/23/2023
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