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General NPI Number Information
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NPI Number | 1396088589
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Entity Type | Organization
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Legal Business Name | ATM TCM AGENCY
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Dates
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Enumeration Date | 04/05/2013
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 1310 W COLONIAL DR SUITE 18
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City | ORLANDO
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State | FL
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Zip | 32804-7139
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Country | US
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Telephone | 407-405-5052
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 W COLONIAL DR SUITE 18
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City | ORLANDO
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State | FL
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Zip | 32804-7139
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Country | US
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Telephone | 407-405-5052
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR/MANAGING PARTNER
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Name | MS. BRENDA THOMPSON
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Credential |
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Telephone | 407-405-5052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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