Organization
TREATMENT ALTERNATIVES FOR SAFE COMMUNITIES
Active
Other names
TASC, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROY FESMIRE (CHIEF FINANCIAL OFFICER)
(312) 787-0208
Entity
Organization
Contact information
Practice address
401 W STATE ST, ROCKFORD, IL 61101-1248
(815) 965-1106
(815) 964-5784
Mailing address
700 S CLINTON ST, CHICAGO, IL 60607-4350
(312) 787-0208
(312) 787-9663
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D0927073
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13001
—
IL
01
—
14D0927073
CLIA LABORATORY CERTIFICATION
IL
05
—
A-0637-0043-A
—
IL
Enumeration date
02/08/2017
Last updated
03/09/2017
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