MEDICARE: TRANQUILITY HOME CARE, INC

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	251E00000X	Home Health Agency	008068	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	019210-0001	OTHER	TX	SECURE HORIZONS PROVIDER
2	7504380	OTHER	TX	AETNA PPO PROVIDER NUMBER
3	019210-0001	OTHER	TX	PACIFICARE PROVIDER NUMBE
4	2964632	OTHER	TX	AETNA HMO PROVIDER NUMBER
5	HH309H	OTHER	TX	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1487657540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUILITY HOME CARE, INC

Provider Business Mailing Address
First Line	:	4231 GATE CRST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-4807
Country	:	US
Telephone Number	:	210-967-0100
Fax Number	:	210-967-0118

Provider Business Practice Location Address
First Line	:	4231 GATE CRST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-4807
Country	:	US
Telephone Number	:	210-967-0100
Fax Number	:	210-967-0118

Authorized Official
Title or Position	:	ADMINISTRATIVE ASSOCIATE
Name	:	MRS. PAULA JEANETTE ALBERTHAL
Credential	:	L.V.N.
Telephone Number	:	210-967-0100

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/22/2020

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Directions to “TRANQUILITY HOME CARE, INC ” Practice Location

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