MEDICARE: TRANQUILITY CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1902504509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUILITY CARE LLC

Provider Business Mailing Address
First Line	:	2002 W TANNER RANCH RD
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85142-4799
Country	:	US
Telephone Number	:	602-774-4892
Fax Number	:

Provider Business Practice Location Address
First Line	:	2002 W TANNER RANCH RD
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85142-4799
Country	:	US
Telephone Number	:	602-774-4892
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE TEAM LEADER
Name	:	MR. BERNARD KOFI AMPONSA DADZIE
Credential	:
Telephone Number	:	678-732-4541

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	02/22/2023

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Directions to “TRANQUILITY CARE LLC ” Practice Location

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