Provider Demographics
NPI:1619366457
Name:TREATMENT ASSESSMENT SCREENING CENTER, INC
Entity Type:Organization
Organization Name:TREATMENT ASSESSMENT SCREENING CENTER, INC
Other - Org Name:TASC, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-254-7328
Mailing Address - Street 1:2234 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-1651
Mailing Address - Country:US
Mailing Address - Phone:602-254-7328
Mailing Address - Fax:
Practice Address - Street 1:2364 KINGMAN AVE
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-4840
Practice Address - Country:US
Practice Address - Phone:928-853-8678
Practice Address - Fax:602-712-0235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC5949251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health