Provider Demographics
NPI:1093421794
Name:TRANQUILITY HYDRATION WELLNESS AESTHETICS LLC
Entity Type:Organization
Organization Name:TRANQUILITY HYDRATION WELLNESS AESTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SADE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISCOE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:682-267-3600
Mailing Address - Street 1:807 HONEY HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3762
Mailing Address - Country:US
Mailing Address - Phone:682-267-3600
Mailing Address - Fax:
Practice Address - Street 1:218 N WALNUT CREEK DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-1755
Practice Address - Country:US
Practice Address - Phone:682-267-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251J00000XAgenciesNursing Care