MEDICARE: TRANQUILITY PARTNERS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	276400000X	Substance Use Disorder Rehabilitation Hospital Unit
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1407343593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUILITY PARTNERS, LLC

Provider Business Mailing Address
First Line	:	800 WASHINGTON AVE N
Second Line	:
City	:	LONG BEACH
State	:	WA
Zip	:	98631-3806
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 WASHINGTON AVE N
Second Line	:
City	:	LONG BEACH
State	:	WA
Zip	:	98631-3806
Country	:	US
Telephone Number	:	202-379-8359
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. THOMAS FELDMAN
Credential	:
Telephone Number	:	202-379-8359

Provider Enumeration Date	:	04/16/2018
Last Update Date	:	02/04/2021

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