Provider Demographics
NPI:1396088589
Name:ATM TCM AGENCY
Entity type:Organization
Organization Name:ATM TCM AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR/MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-405-5052
Mailing Address - Street 1:1310 W COLONIAL DR
Mailing Address - Street 2:SUITE 18
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-7139
Mailing Address - Country:US
Mailing Address - Phone:407-405-5052
Mailing Address - Fax:
Practice Address - Street 1:1310 W COLONIAL DR
Practice Address - Street 2:SUITE 18
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-7139
Practice Address - Country:US
Practice Address - Phone:407-405-5052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health