Provider Demographics
NPI:1528749785
Name:GRASSHOPPER CARE HOME
Entity type:Organization
Organization Name:GRASSHOPPER CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RUDY
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:ROJAS-VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-646-8522
Mailing Address - Street 1:616 MALLARD LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-5397
Mailing Address - Country:US
Mailing Address - Phone:786-646-8522
Mailing Address - Fax:
Practice Address - Street 1:616 MALLARD LAKE BLVD
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-5397
Practice Address - Country:US
Practice Address - Phone:786-646-8522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child