Provider Demographics
NPI:1104786698
Name:BLUEGRASS HEALING PARTNERS LLC
Entity type:Organization
Organization Name:BLUEGRASS HEALING PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:CEO,LSW
Authorized Official - Phone:859-314-6506
Mailing Address - Street 1:773 S DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-9563
Mailing Address - Country:US
Mailing Address - Phone:859-314-6506
Mailing Address - Fax:
Practice Address - Street 1:1613 OLD PARIS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-2108
Practice Address - Country:US
Practice Address - Phone:859-314-6506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-17
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health