Provider Demographics
NPI:1225421316
Name:TRANQUILITY HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:TRANQUILITY HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:DURDEN
Authorized Official - Last Name:LUCIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-307-3721
Mailing Address - Street 1:3110 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-5415
Mailing Address - Country:US
Mailing Address - Phone:404-307-3721
Mailing Address - Fax:404-254-3521
Practice Address - Street 1:3110 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-5415
Practice Address - Country:US
Practice Address - Phone:404-307-3721
Practice Address - Fax:404-254-3521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA012853207V00000X
GASLPOO8207235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty