Organization
TYERRA MANOR, LLC RESIDENTIAL AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SAFFIE S. TUNIS PHD. (CO-CEO/PROGRAM DIRECTOR)
(480) 217-6996
Entity
Organization
Contact information
Practice address
1533 E SUNLAND AVE, PHOENIX, AZ 85040-3269
(602) 268-2538
(602) 268-2538
Mailing address
1533 E SUNLAND AVE, PHOENIX, AZ 85040-3269
(602) 268-2538
(602) 268-2538
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-3122
AZ
Other
Enumeration date
10/02/2008
Last updated
11/09/2008
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