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General NPI Number Information
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NPI Number | 1881403012
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Entity Type | Organization
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Legal Business Name | TRANQUIL HORIZON HEALTH AND WELLNESS OF CENTRAL TEXAS LLC.
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 1530 SUN CITY BLVD
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City | GEORGETOWN
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State | TX
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Zip | 78633-5350
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Country | US
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Telephone | 512-943-2288
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Fax |
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Provider Business Mailing Address
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Address Line | 149 FORT MABRY LOOP
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City | GEORGETOWN
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State | TX
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Zip | 78628-7199
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Country | US
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Telephone | 512-943-2288
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Fax |
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Authorized Official
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Title or Position | HEALTH PSYCHOLOGY SPECIALIST
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Name | TAWANA MCCOU
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Credential | M.S., PSYD (C)
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Telephone | 512-943-2288
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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