Provider Demographics
NPI:1467273169
Name:TRANQUIL JOURNEY PALLIATIVE AND HOSPICE CARE INC
Entity type:Organization
Organization Name:TRANQUIL JOURNEY PALLIATIVE AND HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KHODJAMIRIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-318-5905
Mailing Address - Street 1:10 W BROADWAY STE 24
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84101-2002
Mailing Address - Country:US
Mailing Address - Phone:646-318-5905
Mailing Address - Fax:
Practice Address - Street 1:10 W BROADWAY STE 24
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-2002
Practice Address - Country:US
Practice Address - Phone:646-318-5905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based