Provider Demographics
NPI:1508406745
Name:TAILORED 2 U PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:TAILORED 2 U PSYCHIATRY, PLLC
Other - Org Name:MARGARITA MADRID DBA TAILORED 2 U PSCYHIATRY, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADRID
Authorized Official - Suffix:
Authorized Official - Credentials:FPMHNP-BC
Authorized Official - Phone:602-584-5859
Mailing Address - Street 1:17505 N 79TH AVE STE 311E
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8730
Mailing Address - Country:US
Mailing Address - Phone:602-584-5859
Mailing Address - Fax:602-584-5860
Practice Address - Street 1:17505 N 79TH AVE STE 311E
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8730
Practice Address - Country:US
Practice Address - Phone:602-584-5859
Practice Address - Fax:602-584-5860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ357792Medicaid
AZ1508406745OtherGROUP NPI
AZ1619476207OtherNPI