Provider Demographics
NPI:1609255801
Name:TRANQUILITY MENTAL HEALTH COUNSELING AND WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:TRANQUILITY MENTAL HEALTH COUNSELING AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRATES
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:774-240-9763
Mailing Address - Street 1:37 KINGMAN ST
Mailing Address - Street 2:
Mailing Address - City:EAST TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02718-1407
Mailing Address - Country:US
Mailing Address - Phone:774-240-9763
Mailing Address - Fax:
Practice Address - Street 1:32 NYE AVE
Practice Address - Street 2:
Practice Address - City:ACUSHNET
Practice Address - State:MA
Practice Address - Zip Code:02743-2750
Practice Address - Country:US
Practice Address - Phone:774-226-9927
Practice Address - Fax:774-226-9927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2015-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA118891251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health