MEDICARE: APOLLON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1750659827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APOLLON

Provider Business Mailing Address
First Line	:	5362 DEER CREEK DRIVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254
Country	:	US
Telephone Number	:	317-506-8396
Fax Number	:

Provider Business Practice Location Address
First Line	:	5362 DEER CREEK DRIVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254
Country	:	US
Telephone Number	:	317-506-8396
Fax Number	:

Authorized Official
Title or Position	:	HEALTH CARE PROVIDER
Name	:	MISS GEORGE A. MIDDLETON
Credential	:
Telephone Number	:	317-506-8396

Provider Enumeration Date	:	12/05/2011
Last Update Date	:	12/05/2011

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Directions to “APOLLON ” Practice Location

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