Provider Demographics
NPI:1366732588
Name:TSK ASSISTED LIVING SERVICES, INC,
Entity type:Organization
Organization Name:TSK ASSISTED LIVING SERVICES, INC,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:P
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-297-2000
Mailing Address - Street 1:240 W RIDDLE AVE
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-2949
Mailing Address - Country:US
Mailing Address - Phone:330-297-2000
Mailing Address - Fax:330-297-1896
Practice Address - Street 1:240 W RIDDLE AVE
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-2949
Practice Address - Country:US
Practice Address - Phone:330-297-2000
Practice Address - Fax:330-297-1896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care