MEDICARE: THE GROVE AT LEXINGTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	7100043250	KY
3	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1144401738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GROVE AT LEXINGTON

Provider Business Mailing Address
First Line	:	3150 CUSTER DR
Second Line	:	SUITE 201
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4010
Country	:	US
Telephone Number	:	859-271-1101
Fax Number	:	859-271-1161

Provider Business Practice Location Address
First Line	:	3150 CUSTER DR
Second Line	:	SUITE 201
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4010
Country	:	US
Telephone Number	:	859-271-1101
Fax Number	:	859-271-1161

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. ANGELA DAWN TAYLOR
Credential	:
Telephone Number	:	859-388-4347

Provider Enumeration Date	:	11/24/2007
Last Update Date	:	10/02/2008

Similar Medicare Providers

1952380867 — BARBARA M. SLATER NP, APRN
Practice Location Address:

3150 CUSTER DR
LEXINGTON, KY
40517-4010

Practice Phone: 859-229-0085
Practice Fax:

1851492706 — MR. LARRY DEAN COY LCSW
Practice Location Address:

3150 CUSTER DR , STE 203
LEXINGTON, KY
40517-4010

Practice Phone: 859-271-7788
Practice Fax: 859-273-3306

1568559268 — ELIZABETH SULLINS TOVAR PHD,FNP-C,PMHNP-BC
Practice Location Address:

3150 CUSTER DR STE 101
LEXINGTON, KY
40517-4010

Practice Phone: 859-368-0434
Practice Fax: 859-368-0437

1104971134 — MRS. MELISSA WARD AMMERMAN LCSW
Practice Location Address:

3150 CUSTER DR , SUITE 203
LEXINGTON, KY
40517-4010

Practice Phone: 859-271-7788
Practice Fax: 859-273-3306

1104961952 — ANGELA M MUDD M.S.W.
Practice Location Address:

3150 CUSTER DR , SUITE 203
LEXINGTON, KY
40517-4010

Practice Phone: 859-271-7788
Practice Fax: 859-273-3306

1801059399 — JESUS VICTOR TOVAR M.D.
Practice Location Address:

3150 CUSTER DR STE 101
LEXINGTON, KY
40517-4010

Practice Phone: 859-368-0434
Practice Fax: 859-368-0437

Directions to “THE GROVE AT LEXINGTON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.