Healthcare Provider Details

I. General information

NPI: 1093648131
Provider Name (Legal Business Name): TRANQUILITY CRISIS RESIDENTIAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 38TH ST
NORFOLK VA
23508-2334
US

IV. Provider business mailing address

1350 38TH ST
NORFOLK VA
23508-2334
US

V. Phone/Fax

Practice location:
  • Phone: 757-904-6040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DESHAY N EDWARDS
Title or Position: OWNER
Credential: MSW, LMHP-S
Phone: 757-658-9850