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General NPI Number Information
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NPI Number | 1255149324
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Entity Type | Organization
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Legal Business Name | GEMINI RECOVERY CENTER
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 300 HOPE AVE STE C
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City | COLUMBUS
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State | IN
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Zip | 47201-6454
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Country | US
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Telephone | 812-341-6680
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Fax |
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Provider Business Mailing Address
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Address Line | 300 HOPE AVE STE C
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City | COLUMBUS
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State | IN
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Zip | 47201-6454
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRANDON NIELSEN
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Credential |
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Telephone | 812-341-6680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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