Provider Demographics
NPI:1235399643
Name:BLUEGRASS MENTAL HEALTH AND MENTAL RETARDATION BOARD
Entity Type:Organization
Organization Name:BLUEGRASS MENTAL HEALTH AND MENTAL RETARDATION BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INITIAL SERVICE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ABEER
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BATEH
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:859-271-9448
Mailing Address - Street 1:3161 CUSTER DR
Mailing Address - Street 2:STE. 4
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4067
Mailing Address - Country:US
Mailing Address - Phone:859-271-9448
Mailing Address - Fax:859-272-6893
Practice Address - Street 1:3161 CUSTER DR
Practice Address - Street 2:STE. 4
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-4067
Practice Address - Country:US
Practice Address - Phone:859-271-9448
Practice Address - Fax:859-272-6893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management