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General NPI Number Information
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NPI Number | 1790731081
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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 | 05/26/2006
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Last Update Date | 11/22/2021
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Provider Practice Location Address
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Address Line | 191 DOCTORS DR
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City | FRANKFORT
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State | KY
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Zip | 40601-4101
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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 | 40511-1217
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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 | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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