Organization Active NPI

Sa Rosebud Home LLC

  • Community/Behavioral Health Agency
  • Lexington, KY
National Provider Identifier
1609657568
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SA ROSEBUD HOME LLC
Practice address
444 Glen Arvin Ave
Lexington, KY 40508-1087
Phone
(859) 913-5750
NPI assigned
Oct 6, 2023
Last updated
Aug 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Najam Khan, CMNPI 1205388964
Title
Case Manager
Phone
(561) 779-2123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Recovery Care Clinic/Center 261QR0800X NU
Substance Abuse Rehabilitation Facility 324500000X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

444 Glen Arvin Ave
Lexington, KY 40508-1087

Mailing address

1160 Brick House LN
Lexington, KY 40509-8563
Phone (561) 779-2123

Other practice location 1

1042 Center Dr Ste 111
Richmond, KY 40475-3838
Phone (561) 779-2123

Other practice location 2

234 Rosebud Ave
Irvine, KY 40336-1204
Phone (561) 779-2123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231130003674 KY Part B Supplier - Clinic/Group Practice 0648628602 Receives reassigned benefits from 2 practitioners
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1609657568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 BRICK HOUSE LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405098563",
            "telephone_number": "561-779-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 GLEN ARVIN AVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405081087",
            "telephone_number": "859-913-5750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1042 Center Dr Ste 111",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "KY",
            "postal_code": "404753838",
            "country_code": "US",
            "telephone_number": "561-779-2123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "234 Rosebud Ave",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "KY",
            "postal_code": "403361204",
            "country_code": "US",
            "telephone_number": "561-779-2123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SA ROSEBUD HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-06",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "NAJAM",
        "authorized_official_title_or_position": "CASE MANAGER",
        "authorized_official_telephone_number": "561-779-2123",
        "authorized_official_credential": "CM"
    },
    "taxonomies": [
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.