Provider Demographics
NPI:1588282438
Name:TRANQUILITYHOMECARESERVICES,LLC
Entity type:Organization
Organization Name:TRANQUILITYHOMECARESERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELBOURNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-224-6671
Mailing Address - Street 1:202 CARWEN CT
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-4211
Mailing Address - Country:US
Mailing Address - Phone:704-963-9055
Mailing Address - Fax:
Practice Address - Street 1:202 CARWEN CT
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-4211
Practice Address - Country:US
Practice Address - Phone:704-963-9055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health