MEDICARE: BLUEGRASS CARE GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1427989821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUEGRASS CARE GROUP LLC

Provider Business Mailing Address
First Line	:	5249 FIRE NIGHT AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-6957
Country	:	US
Telephone Number	:	702-481-2775
Fax Number	:

Provider Business Practice Location Address
First Line	:	5249 FIRE NIGHT AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-6957
Country	:	US
Telephone Number	:	702-481-2775
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. LAMONDRE LEWARREN THOMPSON
Credential	:
Telephone Number	:	702-481-2775

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “BLUEGRASS CARE GROUP LLC ” Practice Location

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