NPIMap

Organization Active NPI

Tilda Manor, Inc

  • Psychiatric Residential Treatment Facility
  • Mesa, AZ
National Provider Identifier
1184928285
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
BH3704 Issued in AZ
Legal business name
TILDA MANOR, INC
Practice address
3228 E Isabella Ave
Mesa, AZ 85204-7343
Phone
(602) 561-4800
NPI assigned
Jan 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Samuel Ashu, PHARM.D
Title
Assistant Administrator
Phone
(602) 561-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X BH3704 AZ Primary

Addresses

Primary practice location

3228 E Isabella Ave
Mesa, AZ 85204-7343

Mailing address

3228 E Isabella Ave
Mesa, AZ 85204-7343
Phone (602) 561-4800

National Provider Directory

National Provider Directory
Tax ID family
Tilda Manor5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294099200000",
    "number": "1184928285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3228 E ISABELLA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047343",
            "telephone_number": "602-561-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3228 E ISABELLA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047343",
            "telephone_number": "602-561-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TILDA MANOR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-01-04",
        "status": "A",
        "authorized_official_last_name": "ASHU",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "602-561-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "AZ",
            "license": "BH3704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.