Provider Demographics
NPI:1578337077
Name:TRANQUIL WATERS FOUNDATION INC.
Entity Type:Organization
Organization Name:TRANQUIL WATERS FOUNDATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN-MARIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MIGLIONICO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:407-738-9408
Mailing Address - Street 1:4800 STONE ACRES CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8862
Mailing Address - Country:US
Mailing Address - Phone:407-738-9408
Mailing Address - Fax:321-999-9389
Practice Address - Street 1:12617 NARCOOSSEE RD STE 110
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-7148
Practice Address - Country:US
Practice Address - Phone:407-738-9408
Practice Address - Fax:321-999-9389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty