Provider Demographics
NPI:1386402915
Name:TRANQUILITY PSYCHIATRY SERVICES LLC
Entity type:Organization
Organization Name:TRANQUILITY PSYCHIATRY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABIODUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELOWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-777-7940
Mailing Address - Street 1:8824 WHIRLWIND TRL
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-2281
Mailing Address - Country:US
Mailing Address - Phone:469-777-7940
Mailing Address - Fax:
Practice Address - Street 1:11606 104TH AVENUE CT SW # J
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-1357
Practice Address - Country:US
Practice Address - Phone:469-777-7940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty