Provider Demographics
NPI:1003554346
Name:TRANQUILITY RECOVERY CENTER
Entity Type:Organization
Organization Name:TRANQUILITY RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARGIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MANUKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-444-1404
Mailing Address - Street 1:11310 WENTWORTH ST
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-1138
Mailing Address - Country:US
Mailing Address - Phone:651-200-0000
Mailing Address - Fax:
Practice Address - Street 1:11310 WENTWORTH ST
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-1138
Practice Address - Country:US
Practice Address - Phone:651-200-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder