Healthcare Provider Details

I. General information

NPI: 1982027199
Provider Name (Legal Business Name): BHG XXXIII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2014
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 OLIVET CHURCH RD
PADUCAH KY
42001-9755
US

IV. Provider business mailing address

5001 SPRING VALLEY ROAD, SUITE 600 EAST
DALLAS TX
75244
US

V. Phone/Fax

Practice location:
  • Phone: 270-443-0096
  • Fax: 270-443-0080
Mailing address:
  • Phone: 214-365-6150
  • Fax: 214-365-6150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number800197
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number810129
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateKY

VIII. Authorized Official

Name: JAY HIGHAM
Title or Position: CEO
Credential:
Phone: 214-365-6112