Organization
BHGXXIX, LLC
Active
Other names
BHG Poplar Bluff Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEMECE MICHELLE GASAWAY (DIRECTOR OF LICENSING)
(214) 365-6126
Entity
Organization
Contact information
Practice address
1369 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3313
(573) 772-7937
(573) 778-1315
Mailing address
5001 SPRING VALLEY ROAD, SUITE 600 EAST, DALLAS, TX 75244-5603
(214) 365-6100
(214) 365-6150
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2800X
Methadone Clinic
—
MO
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2014
Last updated
12/17/2019
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