| Tasc, Inc. | |
|
401 W State St Rockford IL 61101-1248 | |
| (815) 965-1106 | |
| (815) 964-5784 |
| Full Name | Tasc, Inc. |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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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