Provider Demographics
NPI:1003425703
Name:APOLLO HEALTH, LLC
Entity Type:Organization
Organization Name:APOLLO HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RACKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-242-1003
Mailing Address - Street 1:11715 RAINWOOD RD STE B6
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-3968
Mailing Address - Country:US
Mailing Address - Phone:479-242-1003
Mailing Address - Fax:479-782-5502
Practice Address - Street 1:11715 RAINWOOD RD STE B6
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-3968
Practice Address - Country:US
Practice Address - Phone:479-242-1003
Practice Address - Fax:479-782-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty