Healthcare Provider Details

I. General information

NPI: 1154688315
Provider Name (Legal Business Name): APOLLO BEHAVIORAL HEALTH HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 12/23/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9938 AIRLINE HWY
BATON ROUGE LA
70816-8100
US

IV. Provider business mailing address

PO BOX 40816
BATON ROUGE LA
70835-0816
US

V. Phone/Fax

Practice location:
  • Phone: 225-663-2881
  • Fax: 225-424-2233
Mailing address:
  • Phone: 225-663-2881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: GOPINATH GOPALAM
Title or Position: CEO
Credential:
Phone: 225-663-2881