Provider Demographics
NPI:1396541686
Name:TRANQUIL HAVEN
Entity type:Organization
Organization Name:TRANQUIL HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETRONELLA
Authorized Official - Middle Name:TAKU
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-961-5144
Mailing Address - Street 1:3425 BANNERMAN RD STE 105-217
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-7062
Mailing Address - Country:US
Mailing Address - Phone:850-567-9707
Mailing Address - Fax:
Practice Address - Street 1:3425 BANNERMAN RD STE 105-217
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-7062
Practice Address - Country:US
Practice Address - Phone:850-567-9707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty