BHG LXVI LLC NPI 1811596646

NPI Information

  • NPI: 1811596646
  • Provider Name: BHG LXVI, LLC
  • Classification: Psychiatry & Neurology - 2084A0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • :
  • CLIA Number: 11D2180726
  • Address: 1021 ALABAMA AVENUE
    BREMEN, GA
    ZIP 30110
  • Phone: (770) 537-7007

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NPI Details

BHG LXVI, LLC is an addiction medicine psychiatry neurology in Bremen, 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 1811596646. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

1021 ALABAMA AVENUE
BREMEN, GA
ZIP 30110
Phone: (770) 537-7007

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

The CLIA number assigned to this NPI record is 11D2180726 - other - office opioid treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/22/2020 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
1207QA0401XFamily MedicineAddiction MedicineNo
2207RA0401XInternal MedicineAddiction MedicineNo
32083A0300XPreventive MedicineAddiction MedicineNo
42084A0401XPsychiatry & NeurologyAddiction MedicineYes
5363L00000XNurse PractitionerNo
6363LP0808XNurse PractitionerPsychiatric/Mental HealthNo

What is NPI?

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This page was last updated on: 3/30/2025

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