Organization
STARK COUNTY TASC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A. WILLS MPA,LICDC (EXECUTIVE DIRECTOR)
(330) 479-1912
Entity
Organization
Contact information
Practice address
624 MARKET AVE N, CANTON, OH 44702-1017
(330) 327-4826
(330) 479-0977
Mailing address
624 MARKET AVE N, CANTON, OH 44702-1017
(330) 327-4826
(330) 479-0977
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08321
MACSIS UPI
OH
Enumeration date
05/24/2006
Last updated
09/28/2020
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