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Organization
BLUEGRASS EXTENDED CARE SERVICES LLC
Active
Organization
BLUEGRASS EXTENDED CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W. RICHARD (OWNER)
(859) 338-3958
Entity
Organization
Contact information
Practice address
989 GOVERNORS LN STE 240, LEXINGTON, KY 40513-1175
(859) 338-3958
(859) 368-8135
Mailing address
989 GOVERNORS LN STE 240, LEXINGTON, KY 40513-1175
(859) 338-3958
(859) 368-8135
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100185160
—
KY
05
—
7100192070
—
KY
05
—
7100206250
—
KY
Enumeration date
11/17/2011
Last updated
01/13/2026
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