Organization
BLUEGRASS PEER SUPPORTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN NELSON (PEER SUPPORT SPECIALIST)
(502) 762-6561
Entity
Organization
Contact information
Practice address
3533 LENTZ AVE, LOUISVILLE, KY 40215-1818
(502) 762-6561
Mailing address
3533 LENTZ AVE, LOUISVILLE, KY 40215-1818
(502) 762-6561
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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