Provider Demographics
NPI:1962225391
Name:FR TOM TIRMAN OSM LLC
Entity type:Organization
Organization Name:FR TOM TIRMAN OSM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GREGOTY
Authorized Official - Last Name:TIRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-393-0725
Mailing Address - Street 1:300 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-2261
Mailing Address - Country:US
Mailing Address - Phone:317-603-0012
Mailing Address - Fax:
Practice Address - Street 1:800 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-1545
Practice Address - Country:US
Practice Address - Phone:765-393-0725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty