=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275097594
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLUEGRASS HOME CARE SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2019
-----------------------------------------------------
Last Update Date | 09/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2039 REGENCY RD STE 1
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40503-2334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-334-0744
-----------------------------------------------------
Fax | 859-376-1153
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2039 REGENCY RD STE 1
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40503-2334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-334-0744
-----------------------------------------------------
Fax | 859-376-1153
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TAMMY SCOTT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 859-334-0744
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------