Provider Demographics
NPI:1811024433
Name:CUYAHOGA COUNTY TASC AGENCY
Entity Type:Organization
Organization Name:CUYAHOGA COUNTY TASC AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-443-5905
Mailing Address - Street 1:1276 W 3RD ST STE 210
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-1512
Mailing Address - Country:US
Mailing Address - Phone:216-443-7265
Mailing Address - Fax:216-698-6924
Practice Address - Street 1:1276 W 3RD ST STE 210
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-1512
Practice Address - Country:US
Practice Address - Phone:216-443-7265
Practice Address - Fax:216-698-6924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2962Medicare UPIN