Provider Demographics
NPI:1821603564
Name:A TRANQUIL CARE HOME AGENCY, LLC
Entity Type:Organization
Organization Name:A TRANQUIL CARE HOME AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:AMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-202-9923
Mailing Address - Street 1:5212 MERWYN AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3037
Mailing Address - Country:US
Mailing Address - Phone:980-202-9934
Mailing Address - Fax:
Practice Address - Street 1:9625 DAVID TAYLOR DR STE 120B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-2362
Practice Address - Country:US
Practice Address - Phone:980-202-9934
Practice Address - Fax:704-800-3481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care