Provider Demographics
NPI:1194977264
Name:TAP RESOURCES INC.
Entity type:Organization
Organization Name:TAP RESOURCES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR - CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLSUP
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CADC
Authorized Official - Phone:309-676-8762
Mailing Address - Street 1:2390 W NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61604-3111
Mailing Address - Country:US
Mailing Address - Phone:309-676-8762
Mailing Address - Fax:309-676-8782
Practice Address - Street 1:2390 W NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61604-3111
Practice Address - Country:US
Practice Address - Phone:309-676-8762
Practice Address - Fax:309-676-8782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA13320001A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty