Individual
GROVER CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1351 NEWTOWN PIKE, LEXINGTON, KY 40511-1275
(859) 253-1686
Mailing address
1351 NEWTOWN PIKE, LEXINGTON, KY 40511-1275
(859) 253-1686
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
KY
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
08/04/2021
Last updated
12/12/2023
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