Provider Demographics
NPI:1114299765
Name:TRANQUILITY CARE LLC
Entity Type:Organization
Organization Name:TRANQUILITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-981-2071
Mailing Address - Street 1:3935 ROCKHOUSE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SALYERSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41465-9099
Mailing Address - Country:US
Mailing Address - Phone:740-981-2071
Mailing Address - Fax:740-776-0667
Practice Address - Street 1:3935 ROCKHOUSE CREEK RD
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-9099
Practice Address - Country:US
Practice Address - Phone:740-981-2071
Practice Address - Fax:740-776-0667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-28
Last Update Date:2012-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities