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General NPI Number Information
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NPI Number | 1619366457
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Entity Type | Organization
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Legal Business Name | TREATMENT ASSESSMENT SCREENING CENTER, INC
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Dates
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Enumeration Date | 01/16/2015
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Last Update Date | 01/16/2015
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Provider Practice Location Address
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Address Line | 2364 KINGMAN AVE
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City | KINGMAN
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State | AZ
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Zip | 86401-4840
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Country | US
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Telephone | 928-853-8678
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Fax | 602-712-0235
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Provider Business Mailing Address
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Address Line | 2234 N 7TH ST
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City | PHOENIX
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State | AZ
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Zip | 85006-1651
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Country | US
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Telephone | 602-254-7328
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DOUGLAS K KRAMER
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Credential |
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Telephone | 602-254-7328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | OTC5949
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License Number State | AZ
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