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General NPI Number Information
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NPI Number | 1336160118
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Entity Type | Organization
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Legal Business Name | TASC OF SOUTHEAST OHIO
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 329 3RD ST
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City | MARIETTA
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State | OH
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Zip | 45750-2902
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Country | US
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Telephone | 740-376-6454
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Fax | 740-376-6457
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Provider Business Mailing Address
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Address Line | 499 JACKSON PIKE PO BOX 88
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1398
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Country | US
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Telephone | 740-441-2924
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Fax | 740-441-2970
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | STEPHEN K THOMAS
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Credential |
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Telephone | 740-441-2924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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