Healthcare Provider Details

I. General information

NPI: 1265181572
Provider Name (Legal Business Name): TRANQUILITY THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 S MARION AVE STE 135
LAKE CITY FL
32025-7000
US

IV. Provider business mailing address

796 SW HUNTER RD
LAKE CITY FL
32024-2939
US

V. Phone/Fax

Practice location:
  • Phone: 386-965-6901
  • Fax: 386-406-8348
Mailing address:
  • Phone: 386-965-6901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY STRATTON
Title or Position: OWNER
Credential: LMHC
Phone: 386-965-6901