Organization · NPI-2
Bhg Xlv, LLC
Clinic/Center, Rehabilitation, Substance Use Disorder · Tifton, GA
NPI number1992241400
StatusActive
Last updated in NPPESDec 27, 2024
Details
- NPI
- 1992241400
- Entity type
- Organization (NPI-2)
- Legal business name
- Bhg Xlv, LLC
- Organization subpart
- No
- Enumeration date
- Jan 9, 2017
- Certification date
- Dec 27, 2024
- Last updated
- Dec 27, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | NTP001047 | GA | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | NTP001047 | GA | |
| 261QM2800X | Clinic/Center, Methadone Clinic | NTP001047 | GA |
Practice location
2402 Tift Ave NSuite 202
Tifton, GA 31794-1883
Phone 757-962-0748
Mailing address
5001 Spring Valley RdSuite 600 East
Dallas, TX 75244-3946
Phone 214-365-6100 · Fax 214-365-6150
Authorized official
Jay Higham
Ceo
2143656112
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