Healthcare Provider Details

I. General information

NPI: 1649813718
Provider Name (Legal Business Name): APOLLO BEHAVIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2019
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 RESEARCH CT STE 125
SUWANEE GA
30024-6606
US

IV. Provider business mailing address

5050 RESEARCH CT STE 125
SUWANEE GA
30024-5573
US

V. Phone/Fax

Practice location:
  • Phone: 404-202-8142
  • Fax:
Mailing address:
  • Phone: 404-410-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. KIM DEAN
Title or Position: CEO
Credential:
Phone: 404-410-7600