MEDICARE: TRANQUILITY HOSPICE CORP

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	163WH1000X	Hospice Registered Nurse
2	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1407503147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUILITY HOSPICE CORP

Provider Business Mailing Address
First Line	:	9037 RENDON ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143-5449
Country	:	US
Telephone Number	:	908-514-1956
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 SPRING MOUNTAIN RD STE 72
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8626
Country	:	US
Telephone Number	:	908-514-1956
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MRS. SANDRA LIMO
Credential	:	BSN RN
Telephone Number	:	908-514-1956

Provider Enumeration Date	:	03/02/2022
Last Update Date	:	10/29/2024

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Directions to “TRANQUILITY HOSPICE CORP ” Practice Location

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