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General NPI Number Information
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NPI Number | 1912950700
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Entity Type | Organization
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Legal Business Name | TANGRAM, INC.
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 5155 PENNWOOD DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46205-1585
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Country | US
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Telephone | 317-571-1042
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Fax | 317-571-1043
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Provider Business Mailing Address
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Address Line | 5155 PENNWOOD DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46205-1585
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Country | US
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Telephone | 317-571-1042
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Fax | 317-571-1043
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. CONNIE DILLMAN
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Credential |
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Telephone | 317-968-9024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 060065951
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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