Provider Demographics
NPI:1316089758
Name:TASC INC.
Entity type:Organization
Organization Name:TASC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:G
Authorized Official - Last Name:AMENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-568-4060
Mailing Address - Street 1:2213 MR OLIVET RD NW
Mailing Address - Street 2:
Mailing Address - City:WAUKAN
Mailing Address - State:IA
Mailing Address - Zip Code:52172-7788
Mailing Address - Country:US
Mailing Address - Phone:563-568-4060
Mailing Address - Fax:563-568-4550
Practice Address - Street 1:2213 MR OLIVET RD NW
Practice Address - Street 2:
Practice Address - City:WAUKAN
Practice Address - State:IA
Practice Address - Zip Code:52172-7788
Practice Address - Country:US
Practice Address - Phone:563-568-4060
Practice Address - Fax:563-568-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0231365Medicaid
IA0115691Medicaid