Organization
TILDA MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL ASHU PHARM.D (ASSISTANT ADMINISTRATOR)
(480) 830-8588
Entity
Organization
Contact information
Practice address
1404 N ANANEA, MESA, AZ 85207-3877
(480) 830-8588
Mailing address
1404 N ANANEA, MESA, AZ 85207-3877
(480) 830-8588
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
BH2325
AZ
Other
Enumeration date
12/27/2006
Last updated
08/22/2020
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