BHG LXVII LLC NPI 1275316697

NPI Information

  • NPI: 1275316697
  • Provider Name: BHG LXVII, LLC
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • :
  • CLIA Number: 15D2305219
  • Address: 3910 LIMA ROAD
    OBOT ROOM 100
    FORT WAYNE, IN
    ZIP 46805
  • Phone: (260) 420-6010

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NPI Details

BHG LXVII, LLC is a multi-specialty clinic center in Fort Wayne, IN. BHG LXVII, LLC NPI is 1275316697. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

3910 LIMA ROAD
OBOT ROOM 100
FORT WAYNE, IN
ZIP 46805-031
Phone: (260) 420-6010
Fax: (260) 420-9020

The provider's authorized official is Anthony Kilgore .
The authorized official title is Ceo and has the following contact phone number (214) 365-6112.

The CLIA number assigned to this NPI record is 15D2305219 - other - office based opioid treat with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/17/2023 and was last updated on 9/22/2025.

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
1103TA0400XPsychologistAddiction (Substance Use Disorder)No
22084A0401XPsychiatry & NeurologyAddiction MedicineNo
3101YA0400XCounselorAddiction (Substance Use Disorder)No
4207QA0401XFamily MedicineAddiction MedicineNo
52083A0300XPreventive MedicineAddiction MedicineNo
6363L00000XNurse PractitionerNo
7363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
8207RA0401XInternal MedicineAddiction MedicineNo
9261QM1300XClinic/CenterMulti-SpecialtyYes

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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