Healthcare Provider Details

I. General information

NPI: 1992092084
Provider Name (Legal Business Name): BLUEGRASS RAPE CRISIS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2011
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 CONSTITUTION ST
LEXINGTON KY
40507-2112
US

IV. Provider business mailing address

145 CONSTITUTION ST
LEXINGTON KY
40507-2112
US

V. Phone/Fax

Practice location:
  • Phone: 859-253-2615
  • Fax:
Mailing address:
  • Phone: 859-253-2615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateKY

VIII. Authorized Official

Name: MS. STEPHANIE HUMES
Title or Position: INTERIM DIRECTOR
Credential: MSW, CSW
Phone: 859-253-2615