MEDICARE: BHG LXXXIV, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM2800X	Methadone Clinic
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	207QA0401X	Addiction Medicine (Family Medicine) Physician
4	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
5	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
6	207RA0401X	Addiction Medicine (Internal Medicine) Physician
7	261QM1300X	Multi-Specialty Clinic/Center
8	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician

General Provider Information

NPI Number	:	1154035236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BHG LXXXIV, LLC

Provider Business Mailing Address
First Line	:	5001 SPRING VALLEY RD STE 600
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-3946
Country	:	US
Telephone Number	:	214-365-6100
Fax Number	:	214-365-6150

Provider Business Practice Location Address
First Line	:	1910 HASKELL AVENUE, SUITE 9
Second Line	:	OBOT ROOM #100
City	:	LAWRENCE
State	:	KS
Zip	:	66046-3296
Country	:	US
Telephone Number	:	785-856-4357
Fax Number	:	785-856-1127

Authorized Official
Title or Position	:	CEO
Name	:	ANTHONY KILGORE
Credential	:
Telephone Number	:	214-365-6112

Provider Enumeration Date	:	01/12/2023
Last Update Date	:	03/02/2026

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Directions to “BHG LXXXIV, LLC ” Practice Location

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