Tasc, Inc. | |
401 W State St Rockford IL 61101-1248 | |
(815) 965-1106 | |
(815) 964-5784 |
Full Name | Tasc, Inc. |
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Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 401 W State St, Rockford, 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 |
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Tasc, Inc. 700 S Clinton St Chicago IL 60607-4350 Ph: (312) 787-0208 | Tasc, Inc. 401 W State St Rockford IL 61101-1248 Ph: (815) 965-1106 |
NPI Number | 1104284587 |
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Provider Enumeration Date | 02/01/2016 |
Last Update Date | 11/28/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104284587 | NPI | - | NPPES |
A-0637-0043-A | Medicaid | IL |
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