MEDICARE: GEMINI RECOVERY CENTER

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
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1255149324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEMINI RECOVERY CENTER

Provider Business Mailing Address
First Line	:	300 HOPE AVE STE C
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-6454
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 HOPE AVE STE C
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-6454
Country	:	US
Telephone Number	:	812-341-6680
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRANDON NIELSEN
Credential	:
Telephone Number	:	812-341-6680

Provider Enumeration Date	:	12/20/2024
Last Update Date	:	02/13/2026

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Directions to “GEMINI RECOVERY CENTER ” Practice Location

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