BHG LXVI LLC NPI 1003510520

NPI Information

  • NPI: 1003510520
  • Provider Name: BHG LXVI, LLC
  • Classification: Psychiatry & Neurology - 2084A0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • :
  • CLIA Number: 11D2300571
  • Address: 794 MCDONOUGH ROAD
    SUITE #104, OBOT ROOM #100
    JACKSON, GA
    ZIP 30233
  • Phone: (770) 775-9044

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NPI Details

BHG LXVI, LLC is an addiction medicine psychiatry neurology in Jackson, GA. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine BHG LXVI, LLC NPI is 1003510520. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

794 MCDONOUGH ROAD
SUITE #104, OBOT ROOM #100
JACKSON, GA
ZIP 30233-572
Phone: (770) 775-9044
Fax: (770) 775-9075

The provider's authorized official is Zack Ragsdale .
The authorized official title is Director and has the following contact phone number (512) 454-5911.

The CLIA number assigned to this NPI record is 11D2300571 - other - opioid treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/28/2023 and was last updated on 4/7/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2207LA0401XAnesthesiologyAddiction MedicineNo
3207QA0401XFamily MedicineAddiction MedicineNo
4207RA0401XInternal MedicineAddiction MedicineNo
52083A0300XPreventive MedicineAddiction MedicineNo
62084A0401XPsychiatry & NeurologyAddiction MedicineYes
7363L00000XNurse PractitionerNo
8363LP0808XNurse PractitionerPsychiatric/Mental HealthNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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