| Tasc Of Southeast Ohio | |
|
499 Jackson Pike Gallipolis OH 45631-1398 | |
| (740) 446-6471 | |
| Not Available |
| Full Name | Tasc Of Southeast Ohio |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 499 Jackson Pike, Gallipolis, Ohio |
| Authorized Official Name and Position | Carrie Burris (FISCAL MANAGER) |
| Authorized Official Contact | 7404466471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tasc Of Southeast Ohio Po Box 88 Gallipolis OH 45631-0088 Ph: (740) 446-6471 | Tasc Of Southeast Ohio 499 Jackson Pike Gallipolis OH 45631-1398 Ph: (740) 446-6471 |
| NPI Number | 1104567577 |
|---|---|
| Provider Enumeration Date | 04/07/2022 |
| Last Update Date | 04/07/2022 |
| Certification Date | 04/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104567577 | NPI | - | NPPES |
| 065834 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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