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Organization

TILDA MANOR

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
6229 S MOCCASIN TRL, GILBERT, AZ 85298-8889
(602) 561-4800
Mailing address
6229 S MOCCASIN TRL, GILBERT, AZ 85298-8889
(602) 561-4800

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH3840
AZ

Other

Enumeration date
09/06/2011
Last updated
09/06/2011
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