BHG XXVIII, LLC (NPI# 1164833877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164833877 |
| Entity Type | Organization |
| Organization Name | BHG XXVIII, LLC |
| Practice Address |
1639 Bruce Smith Pkwy West Plains MO 65775-7691 |
| Mailing Address |
5001 Spring Valley Road Suite 600 East Dallas TX 75244-3946 |
| Practice Telephone | 4172571833 |
| Practice Fax Number | 4172560488 |
| Mailing Telephone | 2143656100 |
| Mailing Fax Number | 2143656150 |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2019-02-20 |
| Authorized Official Name | JEMECE MICHELLE GASAWAY (DIRECTOR OF LICENSING) |
| Authorized Official Telephone | 2143656126 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
MO | Ambulatory Health Care Facilities | |
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
1941 | MO | Ambulatory Health Care Facilities |
| Street Address |
1639 BRUCE SMITH PKWY |
| City | WEST PLAINS |
| State | MO |
| Zip Code | 65775-7691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467923458 | Brittany Jackson | Licensed Practical Nurse | 1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 | 2018-12-17 |
| 1750827028 | Michelle Bryan | Counselor | 1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 | 2017-01-11 |
| 1053789933 | William Stines | Licensed Practical Nurse | 1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 | 2015-09-09 |
| 1700272754 | Jennifer Wilkins | Counselor | 1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 | 2015-04-07 |
| 1558757518 | Crystal Voyles | Licensed Practical Nurse | 1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 | 2015-04-07 |
| 1881098515 | Tess Margaret Miley | Counselor | 1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 | 2014-10-09 |
| 1841694585 | Amanda Woodward | Registered Nurse | 1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 | 2014-10-09 |
| 1750785499 | Melissa Bassham | Registered Nurse | 1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 | 2014-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598373359 | Ozarks Medical Center | Clinic/Center | Omc/zizzer Clinic, 1013 College Street, West Plains, MO 65775 | 2020-07-17 |
| 1962958678 | Fanny Ray | Massage Therapist | 1105 Independence Drive, West Plains, MO 65775 | 2016-09-01 |
| 1295184166 | Shaunda Faye Wolfe | Case Manager/Care Coordinator | 2301 K Hwy Apt. 2, West Plains, MO 65775 | 2016-06-10 |
| 1740694009 | Mary Loretta Rogganbuck | Counselor | 1211 Porter Wagoner #23, West Plains, MO 65775 | 2014-06-16 |
| 1548673858 | John Tollenaar | Physical Therapist | 1480 8th Streeet, West Plains, MO 65775 | 2014-06-04 |
| 1861818080 | Raymond Eugene Richardson | Case Manager/Care Coordinator | 1015 Lanton Road, West Plains, MO 65775 | 2014-03-12 |
| 1710309083 | Jared M Sadowitz | Physical Therapist | 1100 Kentucly Ave, West Plains, MO 65775 | 2014-01-06 |
| 1346682184 | Mark L. Dake Dds, Msd and David Sander Dmd, Mds | Dentist | 181 N. Kentucky, Suite 300, West Plains, MO 65775 | 2013-07-22 |
| 1427307024 | Anita M. Nelson | Behavioral Analyst | 8388 Pr 2731, West Plains, MO 65775 | 2012-08-29 |
| 1780959684 | Ozarks Medical Center | Pharmacy | 18 Parkway Center, West Plains, MO 65775 | 2012-03-12 |
| Find all providers in zip 65775 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255570180 | Family Counseling Center, Inc. | Clinic/Center | 1015 Lanton Rd, West Plains, MO 65775-3854 | 2009-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487179057 | Gateway Foundation, Inc. | Clinic/Center | 1430 Olive St Ste 300, Saint Louis, MO 63103-2303 | 2017-08-04 |
| 1700233145 | New Beginnings C-star | Clinic/Center | 1408 N Kingshighway Blvd Ste 4, Saint Louis, MO 63113-1426 | 2016-05-16 |
| 1629432182 | Clark Community Mental Health Center | Clinic/Center | 1701 N Central Ave, Monett, MO 65708 | 2016-04-11 |
| 1083024061 | Avertest, LLC | Clinic/Center | 4709 Laguardia Dr, Suite 100, Saint Louis, MO 63134 | 2014-04-30 |
| 1659718609 | Hannibal Council On Alcohol & Drug Abuse | Clinic/Center | 146 Communication Dr, Hannibal, MO 63401-3672 | 2013-05-31 |
| 1194026765 | Family Counseling Center, Inc. | Clinic/Center | 500 Us Hwy 61 North, Hayti, MO 63851 | 2010-11-12 |
| 1942501143 | Swope Health Services | Clinic/Center | 3950 E 51st St, Kansas City, MO 64130-3081 | 2010-11-04 |
| 1750682043 | Black Alcohol/drug Service Information Center | Clinic/Center | 3026 Locust St, Saint Louis, MO 63103-1329 | 2010-11-03 |
| 1932412186 | Comprehensive Mental Health Services, Inc/renaisance West | Clinic/Center | 5840 Swope Pkwy, Kansas City, MO 64130-4262 | 2010-07-16 |
| 1609194448 | Southeast Missouri Behavioral Health | Clinic/Center | 216 Piedmont Ave Ste 304, Piedmont, MO 63957-1017 | 2010-05-04 |
| Find all providers with the same taxonomy | ||||
| City | WEST PLAINS |
| Zip Code | 65775 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.