Organization
TILDA MANOR, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL ASHU PHARMD (ASSISTANT ADMINISTRATOR)
(480) 329-9338
Entity
Organization
Contact information
Practice address
5985 S MACK CT, GILBERT, AZ 85298-8711
(480) 329-9338
Mailing address
5985 S MACK CT, GILBERT, AZ 85298-8711
(480) 329-9338
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH3133
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
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Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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