Healthcare Provider Details

I. General information

NPI: 1528164597
Provider Name (Legal Business Name): CARETENDERS OF THE BLUEGRASS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2432 REGENCY RD SUITE 150
LEXINGTON KY
40503-2928
US

IV. Provider business mailing address

9510 ORMSBY STATION RD SUITE 300
LOUISVILLE KY
40223-4081
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-5369
  • Fax: 859-276-1783
Mailing address:
  • Phone: 502-891-1000
  • Fax: 502-891-8067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number150082
License Number StateKY

VIII. Authorized Official

Name: MR. PATRICK TODD LYLES
Title or Position: SR. V.P., ADMINISTRATION
Credential:
Phone: 502-891-1044