| Tangram, Inc. | |
|
5155 Pennwood Dr Indianapolis IN 46205-1585 | |
| (317) 571-1042 | |
| (317) 571-1043 |
| Full Name | Tangram, Inc. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5155 Pennwood Dr, Indianapolis, Indiana |
| Authorized Official Name and Position | Connie Dillman (PRESIDENT/CEO) |
| Authorized Official Contact | 3179689024 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tangram, Inc. 5155 Pennwood Dr Indianapolis IN 46205-1585 Ph: (317) 571-1042 | Tangram, Inc. 5155 Pennwood Dr Indianapolis IN 46205-1585 Ph: (317) 571-1042 |
| NPI Number | 1912950700 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 11/06/2023 |
| Certification Date | 11/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912950700 | NPI | - | NPPES |
| 100450620 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 251E00000X | Home Health | 060065951 (Indiana) | Secondary |
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