Provider Demographics
NPI:1508160862
Name:TRANQUILITY HOME HEALTH AND RESPITE CARE
Entity Type:Organization
Organization Name:TRANQUILITY HOME HEALTH AND RESPITE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEVACIA
Authorized Official - Middle Name:TAMAR
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:313-826-8737
Mailing Address - Street 1:7607 DOBEL ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-3913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28820 SOUTHFIELD RD
Practice Address - Street 2:SUITE NUMBER 123
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-2724
Practice Address - Country:US
Practice Address - Phone:313-826-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care