MEDICARE: TRANQUILITY BEHAVIORAL SOLUTIONS, 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1619389103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUILITY BEHAVIORAL SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	2014 EDGEWATER DR
Second Line	:	SUITE 318
City	:	ORLANDO
State	:	FL
Zip	:	32804-5312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2014 EDGEWATER DR
Second Line	:	SUITE 318
City	:	ORLANDO
State	:	FL
Zip	:	32804-5312
Country	:	US
Telephone Number	:	407-603-6181
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHRISTINA BENSON
Credential	:
Telephone Number	:	407-603-6181

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	06/02/2014

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