Provider Demographics
NPI:1093471385
Name:NULEASE MEDICAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:NULEASE MEDICAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:CALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-492-7455
Mailing Address - Street 1:5722 OUTER LOOP
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-4156
Mailing Address - Country:US
Mailing Address - Phone:502-492-7455
Mailing Address - Fax:
Practice Address - Street 1:854 TUNNEL HILL RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-8064
Practice Address - Country:US
Practice Address - Phone:502-492-7455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility