Healthcare Provider Details
I. General information
NPI: 1285280016
Provider Name (Legal Business Name): BHG L, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/16/2019
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1501 WALDRON ROAD STE 203
FORT SMITH AR
72903
US
IV. Provider business mailing address
5001 SPRING VALLEY RD STE 600E
DALLAS TX
75244-8217
US
V. Phone/Fax
- Phone: 479-769-2880
- Fax: 479-769-2871
- Phone: 214-365-6100
- Fax: 214-365-6150
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083A0300X |
| Taxonomy | Addiction Medicine (Preventive Medicine) Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084A0401X |
| Taxonomy | Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAY
HIGHAM
Title or Position: CEO
Credential:
Phone: 214-365-6112