MEDICARE: TRANQUILITY CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1013384411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUILITY CARE, INC.

Provider Business Mailing Address
First Line	:	1812 CRATER ST
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-3125
Country	:	US
Telephone Number	:	805-422-8480
Fax Number	:	805-422-8524

Provider Business Practice Location Address
First Line	:	1812 CRATER ST
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-3125
Country	:	US
Telephone Number	:	805-422-8480
Fax Number	:	805-422-8524

Authorized Official
Title or Position	:	CEO
Name	:	AMANDA SAENZ
Credential	:
Telephone Number	:	805-422-8480

Provider Enumeration Date	:	09/01/2015
Last Update Date	:	09/01/2015

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Directions to “TRANQUILITY CARE, INC. ” Practice Location

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