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Contact Information

BOURBON HEIGHTS, INC.
2000 MAIN ST
PARIS, KY40361-1149
 Phone: 859-987-5750
 Fax: 859-987-6460
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
 

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Supports Brokerage

251X00000X
Indicates primary specialty

NPI Profile & details for BOURBON HEIGHTS, INC.

NPI # 1053344457
LBN Legal business name BOURBON HEIGHTS, INC.
Authorized official TOM DAVIS - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/09/2006
Last updated 05/19/2026 - About 3 weeks ago
Identifiers
KY License # 100024
KY Medicaid 12501664
Other 000000054629 ANTHEM BLUE CROSS BLUE SH
Other 19401888 SUMMIT WORKER'S COMP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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