| Organization Name: | BLUEGRASS.ORG INC |
| NPI Number: | 1043250095 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL BEATRICE (PRESIDENT/CEO) |
| Mailing Address: | 203 N Main St Stanton |
| State: | KY US |
| Postal Code: | 403802175 |
| Phone Number: | 8592531686 |
| Fax Number: | 8592542743 |
| NPI Enumeration Date: | 06/07/2006 |
| NPI Last Update Date: | 02/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 800121 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |