Healthcare Provider Details

I. General information

NPI: 1013537042
Provider Name (Legal Business Name): TRANQUILITY WELLNESS SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N 5TH AVE APT 350
PHOENIX AZ
85003-0805
US

IV. Provider business mailing address

555 N 5TH AVE APT 350
PHOENIX AZ
85003-0805
US

V. Phone/Fax

Practice location:
  • Phone: 623-336-1766
  • Fax: 602-926-8000
Mailing address:
  • Phone: 623-336-1766
  • Fax: 602-926-8000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN MICHAEL KEENE
Title or Position: OWNER
Credential: OTD, OTR/L
Phone: 623-336-1766