# TILDA MANOR, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184928285
- **Authorized official:** DR. SAMUEL ASHU PHARM.D (ASSISTANT ADMINISTRATOR)
- **Authorized official phone:** (602) 561-4800

## Contact information

- **Practice address:** 3228 E ISABELLA AVE, MESA, AZ 85204-7343
- **Practice address phone:** (602) 561-4800
- **Mailing address:** 3228 E ISABELLA AVE, MESA, AZ 85204-7343
- **Mailing address phone:** (602) 561-4800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | BH3704 | AZ | Yes |

## Other

- **Enumeration date:** 01/04/2011
- **Last updated:** 01/04/2011