Organization
TRACYS RESIDENTIAL RE ENTRY CENTER INC
Active
Other names
Tracy's House, Unbridled Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHIQUITA SHIELDS (PRESIDENT/DIRECTOR)
(859) 229-8027
Entity
Organization
Contact information
Practice address
1365 DEVONPORT DR, LEXINGTON, KY 40504-1552
(859) 309-2240
Mailing address
1365 DEVONPORT DR, LEXINGTON, KY 40504-1512
(859) 309-2240
(859) 800-5261
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800505
CHFS
KY
01
—
811063
COMMONWEALTH OF KENTUCKY, CABINET FOR HEALTH AND FAMILY SERVICES
KY
Enumeration date
10/03/2022
Last updated
11/18/2025
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