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Organization

NGEL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NGOZI AZUBIKE TILLEY QMHP (CO-OWNER)
(972) 986-2470
Entity
Organization

Contact information

Practice address
3939 US HIGHWAY 80 E, STE 305, MESQUITE, TX 75150-3359
(972) 698-0404
(972) 698-0844
Mailing address
3939 US HIGHWAY 80 E, STE 305, MESQUITE, TX 75150-3359
(972) 698-0404
(972) 698-0844

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
TX

Other

Enumeration date
03/28/2013
Last updated
03/28/2013
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