Organization
BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC
Active
Parent organization
CULTIVATE BEHAVIORAL MANAGEMENT CORP
Other names
Cultivate Behavioral Health and Education
Organization subpart
Yes
Provider details
NPI number
Legal business name
CULTIVATE BEHAVIORAL MANAGEMENT CORP
Authorized official
JONATHON CURLETT (CFO)
(469) 955-1099
Entity
Organization
Contact information
Practice address
925 DUDLEY PIKE, EDGEWOOD, KY 41017-8120
(859) 360-3006
(859) 360-3053
Mailing address
12600 HILL COUNTRY BLVD STE R-100, BEE CAVE, TX 78738-6748
(512) 772-4042
(512) 842-7446
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100446170
—
KY
Enumeration date
02/13/2017
Last updated
05/04/2021
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