NPIMap

Organization Active NPI

Tilda Manor II

  • Psychiatric Residential Treatment Facility
  • Gilbert, AZ
National Provider Identifier
1811043524
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
BH2683 Issued in AZ
Legal business name
TILDA MANOR II
Practice address
3583 E Wildhorse Dr
Gilbert, AZ 85297-7745
Phone
(480) 988-5611
Fax
(480) 988-5611
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X BH2683 AZ Primary

Addresses

Primary practice location

3583 E Wildhorse Dr
Gilbert, AZ 85297-7745

Mailing address

1404 N Ananea
Mesa, AZ 85207-3877
Phone (480) 830-8588

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": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811043524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 N ANANEA",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852073877",
            "telephone_number": "480-830-8588",
            "fax_number": "480-830-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3583 E WILDHORSE DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977745",
            "telephone_number": "480-988-5611",
            "fax_number": "480-988-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TILDA MANOR II",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-08-22",
        "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": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "AZ",
            "license": "BH2683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.