Organization
TILDA MANOR, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL ASHU PHARM.D (ASSISTANT ADMINISTRATOR)
(602) 561-4800
Entity
Organization
Contact information
Practice address
3228 E ISABELLA AVE, MESA, AZ 85204-7343
(602) 561-4800
Mailing address
3228 E ISABELLA AVE, MESA, AZ 85204-7343
(602) 561-4800
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
BH3704
AZ
Other
Enumeration date
01/04/2011
Last updated
01/04/2011
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