Healthcare Provider Details
I. General information
NPI: 1568908077
Provider Name (Legal Business Name): BHG XLIV, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2017
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2607 LEDO RD
ALBANY GA
31707-1211
US
IV. Provider business mailing address
5001 SPRING VALLEY RD SUITE 600 EAST
DALLAS TX
75244-3946
US
V. Phone/Fax
- Phone: 229-903-0022
- Fax:
- Phone: 214-365-6100
- Fax: 214-365-6150
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | NTP001025 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM2800X |
| Taxonomy | Methadone Clinic |
| License Number | NTP001025 |
| License Number State | GA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | NTP001025 |
| License Number State | GA |
VIII. Authorized Official
Name:
JAY
HIGHAM
Title or Position: CEO
Credential:
Phone: 214-365-6112