BHG MEDICAL SERVICES - IDAHO
NPI 1194435123
Clinic/Center - Rehabilitation, Substance Use Disorder in Boise, ID
- Organization
- Clinic/Center
- Rehabilitation, Substance Use Disorder
- CLIA Number: 13D2306051
- CLIA Cert. Type: Other - OFFICE BASED OPIOID TREAT
- CLIA Exp. Date: 06-10-2028
About BHG MEDICAL SERVICES - IDAHO
This page provides the complete NPI Profile along with additional information for Bhg Medical Services - Idaho, a provider established in Boise, Idaho operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1194435123 assigned on November 2022. The practitioner's primary taxonomy code is 261QR0405X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Bhg Medical Services - Idaho. The authorized official of this NPI record is Zack Ragsdale (Director)
- NPI
- 1194435123 Verify this NPI
- Provider Legal Name
- BHG LXXXVII, LLC
- Other Organization Name
- BHG MEDICAL SERVICES - IDAHO
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 92 S COLE RD OBOT ROOM #100 BOISE, ID 83709
- Location Phone
- (208) 376-5021
- Location Fax
- (208) 376-5020
- Mailing Address
- 5001 SPRING VALLEY ROAD SUITE 600 EAST DALLAS, TX 75244
- Mailing Phone
- (214) 365-6100
- Mailing Fax
- (214) 365-6150
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-30-2022
- Last Update Date
- 09-23-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rehabilitation, Substance Use Disorder
- Taxonomy Code
- 261QR0405X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | |
| 2 | 261QM2800X | Ambulatory Health Care Facilities | Clinic/Center |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 13D2306051
- Facility Type
- Other - OFFICE BASED OPIOID TREAT
- Certificate Effective Date
- June 11, 2026
- Certificate Expiration Date
- June 10, 2028
- Laboratory Director
- ALISHA LEWIS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Bhg Medical Services - Idaho to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194435123, enumerated as an "organization" on November 30, 2022.
The provider is located at 92 S COLE RD OBOT ROOM #100 BOISE, ID 83709 and the phone number is (208) 376-5021.
Clinic/Center with taxonomy code 261QR0405X and a focus in Rehabilitation, Substance Use Disorder.
