MEDICARE: TRANQUILITY RECOVERY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	261QD1600X	Developmental Disabilities Clinic/Center
3	261QM2800X	Methadone Clinic
4	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
5	324500000X	Substance Abuse Rehabilitation Facility
6	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1033800982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUILITY RECOVERY LLC

Provider Business Mailing Address
First Line	:	3870 E FLAMINGO RD # A2-101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-6228
Country	:	US
Telephone Number	:	702-706-5515
Fax Number	:

Provider Business Practice Location Address
First Line	:	4935 E CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-6402
Country	:	US
Telephone Number	:	702-706-5515
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	VREGH AMIRIAN
Credential	:
Telephone Number	:	702-706-5515

Provider Enumeration Date	:	05/19/2023
Last Update Date	:	05/19/2023

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Directions to “TRANQUILITY RECOVERY LLC ” Practice Location

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