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General NPI Number Information
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NPI Number | 1770298846
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Entity Type | Organization
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Legal Business Name | BHG LXXXV, LLC
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 2437 N. STONE AVE OBOT ROOM #100
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City | TUCSON
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State | AZ
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Zip | 85705-4528
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Country | US
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Telephone | 520-624-0250
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Fax | 520-623-7909
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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