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General NPI Number Information
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NPI Number | 1043914591
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Entity Type | Organization
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Legal Business Name | BHG LXVI, LLC
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Dates
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Enumeration Date | 03/29/2023
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 2402 TIFT AVENUE NORTH SUITE #202, OBOT ROOM #100
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City | TIFTON
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State | GA
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Zip | 31794-1885
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Country | US
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Telephone | 229-382-7808
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Fax | 229-386-5818
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Provider Business Mailing Address
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Address Line | 5001 SPRING VALLEY ROAD SUITE 600 EAST
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City | DALLAS
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State | TX
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Zip | 75244-3946
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Country | US
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Telephone | 214-365-6100
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Fax | 214-365-6150
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Authorized Official
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Title or Position | DIRECTOR
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Name | ZACK RAGSDALE
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Credential |
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Telephone | 512-454-5911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LA0401X
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Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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