Healthcare Provider Details

I. General information

NPI: 1407503147
Provider Name (Legal Business Name): TRANQUILITY HOSPICE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 SPRING MOUNTAIN RD STE 72
LAS VEGAS NV
89102-8626
US

IV. Provider business mailing address

9037 RENDON ST
LAS VEGAS NV
89143-5449
US

V. Phone/Fax

Practice location:
  • Phone: 908-514-1956
  • Fax:
Mailing address:
  • Phone: 908-514-1956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANDRA LIMO
Title or Position: OWNER/ADMINISTRATOR
Credential: BSN RN
Phone: 908-514-1956