Healthcare Provider Details

I. General information

NPI: 1942943154
Provider Name (Legal Business Name): TRANQUILITY HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 SW BONWOLD ST
PORT SAINT LUCIE FL
34953-5022
US

IV. Provider business mailing address

3660 SW BONWOLD ST
PORT SAINT LUCIE FL
34953-5022
US

V. Phone/Fax

Practice location:
  • Phone: 570-242-1768
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANTHONY CAMAEREI
Title or Position: DIR
Credential: MBA
Phone: 570-242-1768