MEDICARE: BHG XXXIII, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency	800197	KY
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	261QM2800X	Methadone Clinic	810129	KY
4	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center		KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982027199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BHG XXXIII, LLC

Provider Business Mailing Address
First Line	:	5001 SPRING VALLEY ROAD,
Second Line	:	SUITE 600 EAST
City	:	DALLAS
State	:	TX
Zip	:	75244
Country	:	US
Telephone Number	:	214-365-6150
Fax Number	:	214-365-6150

Provider Business Practice Location Address
First Line	:	2705 OLIVET CHURCH RD
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-9755
Country	:	US
Telephone Number	:	270-443-0096
Fax Number	:	270-443-0080

Authorized Official
Title or Position	:	CEO
Name	:	JAY HIGHAM
Credential	:
Telephone Number	:	214-365-6112

Provider Enumeration Date	:	01/23/2014
Last Update Date	:	12/27/2024

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