| Tasc, Inc. | |
|
340 S Fillmore St Edwardsville IL 62025-2115 | |
| (618) 656-7672 | |
| (618) 656-7938 |
| Full Name | Tasc, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 340 S Fillmore St, Edwardsville, Illinois |
| Authorized Official Name and Position | Roy Fesmire (VICE PRESIDENT AND CFO) |
| Authorized Official Contact | 3127870208 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tasc, Inc. 700 S Clinton St Chicago IL 60607-4350 Ph: (312) 787-0208 | Tasc, Inc. 340 S Fillmore St Edwardsville IL 62025-2115 Ph: (618) 656-7672 |
| NPI Number | 1639533904 |
|---|---|
| Provider Enumeration Date | 04/12/2016 |
| Last Update Date | 12/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639533904 | NPI | - | NPPES |
| 13001 | Medicaid | IL |
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