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General NPI Number Information
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NPI Number | 1457391344
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Entity Type | Organization
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Legal Business Name | NEW VISTA OF THE BLUEGRASS INC
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 415 GIBSON LN
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City | RICHMOND
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State | KY
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Zip | 40475-2577
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Country | US
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Telephone | 859-253-1686
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Fax | 859-254-2743
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Provider Business Mailing Address
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Address Line | 1351 NEWTOWN PIKE
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City | LEXINGTON
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State | KY
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Zip | 40511-1275
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Country | US
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Telephone | 859-253-1686
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Fax | 859-254-2743
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. DEE WERLINE
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Credential |
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Telephone | 859-253-1686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 800121
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License Number State | KY
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