Provider Demographics
NPI:1033837802
Name:TRANQUILITY TELEPSYCHIATRY LLC
Entity Type:Organization
Organization Name:TRANQUILITY TELEPSYCHIATRY LLC
Other - Org Name:TRANQUILITY TELEPSYCHIATRY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JABARI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:206-761-6046
Mailing Address - Street 1:PO BOX 181
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31402-0181
Mailing Address - Country:US
Mailing Address - Phone:206-761-6046
Mailing Address - Fax:201-761-6047
Practice Address - Street 1:201 W ANDERSON ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401
Practice Address - Country:US
Practice Address - Phone:206-761-6046
Practice Address - Fax:206-761-6047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty