Organization
BLUEGRASS BEHAVIORAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOCCARA C COLEMAN (BILLING SPECIALIST)
(859) 251-4353
Entity
Organization
Contact information
Practice address
527 MARSAILLES RD STE 3, VERSAILLES, KY 40383-1911
(859) 251-4353
(859) 251-4253
Mailing address
229 S STOURBRIDGE RD, VERSAILLES, KY 40383-2001
(859) 494-1421
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71006679420
—
KY
Enumeration date
07/17/2020
Last updated
04/01/2021
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