BHG Lxxxvii, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

BHG LXXXVII, LLC

Doing business as

BHG Medical Services - Idaho

Practice address

2426 N Merritt Creek Loop, Suite B
Obot Room #100
Coeur D'Alene, ID 83814-4961

Phone

(208) 296-5385

Fax

(208) 296-5387

NPI assigned

Jan 18, 2023

Last updated

Sep 23, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Zack Ragsdale

Title

Director

Phone

(512) 454-5911

Specialties & licenses 3

Addresses

Other names 1

• BHG Medical Services - Idaho Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• BHG Lxxxvii, LLC

  dba BHG Medical Services - Idaho

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Boise, ID
  • NPI 1194435123

  O20230829002579

  Same enrollment
• BHG Lxxxvii, LLC

  dba BHG Medical Services - Idaho

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Meridian, ID
  • NPI 1770298465

  O20230829002579

  Same enrollment

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1235844820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 SPRING VALLEY ROAD",
            "address_2": "SUITE 600 EAST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443946",
            "telephone_number": "214-365-6100",
            "fax_number": "214-365-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 N MERRITT CREEK LOOP, SUITE B",
            "address_2": "OBOT ROOM #100",
            "city": "COEUR D'ALENE",
            "state": "ID",
            "postal_code": "838144961",
            "telephone_number": "208-296-5385",
            "fax_number": "208-296-5387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHG LXXXVII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-18",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "RAGSDALE",
        "authorized_official_first_name": "ZACK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "512-454-5911"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BHG Medical Services - Idaho",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BHG Medical Services - Idaho",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Joy Bertsch, D.O.
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• Brittany Tyson Bianchin, NP
• Robin Bianco, LCPC
• Scott David Bieber, D.O.
• Timothy Biediger, RPH
• Big Lake Psychological Services, PC

• Substance Use Disorder Rehabilitation Clinic/Center in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.