Provider Demographics
NPI:1790367688
Name:TRANQUIL HEART, A NJ NONPROFIT CORPORATION
Entity Type:Organization
Organization Name:TRANQUIL HEART, A NJ NONPROFIT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCADC
Authorized Official - Phone:609-379-3693
Mailing Address - Street 1:PO BOX 3134339 HIGHWAY 33, STE 2,
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-0134
Mailing Address - Country:US
Mailing Address - Phone:609-379-3693
Mailing Address - Fax:
Practice Address - Street 1:339 HIGHWAY 33 STE 2
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-4420
Practice Address - Country:US
Practice Address - Phone:609-379-3693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
123OtherHEALTH INSURANCE