Provider Demographics
NPI:1770082588
Name:TRANQUILITY RESOURCE MANAGEMENT
Entity type:Organization
Organization Name:TRANQUILITY RESOURCE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUDREENA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-488-1425
Mailing Address - Street 1:7324 MOUNTAIN THICKET ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-4526
Mailing Address - Country:US
Mailing Address - Phone:702-488-1425
Mailing Address - Fax:
Practice Address - Street 1:7324 MOUNTAIN THICKET ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-4526
Practice Address - Country:US
Practice Address - Phone:702-488-1425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20181083391251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health