MEDICARE: BHG LXXXII, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	207QA0401X	Addiction Medicine (Family Medicine) Physician
4	2083A0300X	Addiction Medicine (Preventive Medicine) Physician
5	207LA0401X	Addiction Medicine (Anesthesiology) Physician
6	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
7	1041C0700X	Clinical Social Worker
8	207RA0401X	Addiction Medicine (Internal Medicine) Physician
9	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician

General Provider Information

NPI Number	:	1639889637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BHG LXXXII, 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	:	3470 W CHEYENNE AVE STE 400
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-8244
Country	:	US
Telephone Number	:	702-636-0085
Fax Number	:	702-636-0087

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

Provider Enumeration Date	:	11/30/2022
Last Update Date	:	09/22/2025

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Directions to “BHG LXXXII, LLC ” Practice Location

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