Healthcare Provider Details
I. General information
NPI: 1689072688
Provider Name (Legal Business Name): BHG XXXVII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/08/2014
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
414 HOSPITAL DR
CLYDE NC
28721-8026
US
IV. Provider business mailing address
5001 SPRING VALLEY ROAD SUITE 600 EAST
DALLAS TX
75244-3946
US
V. Phone/Fax
- Phone: 828-454-0560
- Fax: 828-252-9512
- Phone: 214-365-6100
- Fax: 214-365-6150
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | NC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | NC |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM2800X |
| Taxonomy | Methadone Clinic |
| License Number | |
| License Number State | NC |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | NC |
VIII. Authorized Official
Name:
JAY
HIGHAM
Title or Position: CEO
Credential:
Phone: 214-365-6112