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General NPI Number Information
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NPI Number | 1962970046
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Entity Type | Organization
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Legal Business Name | TRANQUIL HAVEN RESIDENTIAL CARE
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 37 MOSSGLEN CIR
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City | SACRAMENTO
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State | CA
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Zip | 95826-1722
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Country | US
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Telephone | 916-400-3712
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Fax | 916-382-4854
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Provider Business Mailing Address
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Address Line | 11880 SLATE FALLS WAY
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City | RANCHO CORDOVA
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State | CA
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Zip | 95742-8017
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Country | US
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Telephone | 916-294-5227
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. RAQUEL T HENRY
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Credential |
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Telephone | 916-400-3712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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