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General NPI Number Information
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NPI Number | 1023242096
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Entity Type | Organization
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Legal Business Name | TRANQUILITY HEALTH INCORPORATED
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 113 UPPER RIVERDALE ROAD
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City | RIVERDALE
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State | GA
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Zip | 30274
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Country | US
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Telephone | 770-727-2943
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Fax | 866-864-3408
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Provider Business Mailing Address
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Address Line | 2220 JOHNSON CREEK DRIVE
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City | LITHONIA
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State | GA
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Zip | 30058
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Country | US
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Telephone | 770-727-2943
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Fax | 866-864-3408
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Authorized Official
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Title or Position | CEO
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Name | MRS. CAMELIA DOUGLAS
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Credential |
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Telephone | 770-727-2943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | GA
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