Provider Demographics
NPI:1215820758
Name:SHALOM TRANQUIL SERVICES LLC
Entity type:Organization
Organization Name:SHALOM TRANQUIL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGAN-GABISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-904-2034
Mailing Address - Street 1:28 W RADISON RUN
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:DE
Mailing Address - Zip Code:19938-3824
Mailing Address - Country:US
Mailing Address - Phone:484-904-2034
Mailing Address - Fax:
Practice Address - Street 1:28 W RADISON RUN
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:DE
Practice Address - Zip Code:19938-3824
Practice Address - Country:US
Practice Address - Phone:484-904-2034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home