Provider Demographics
NPI:1720813280
Name:TRANQUILITY HEALTHCARE AND BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:TRANQUILITY HEALTHCARE AND BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:832-788-3668
Mailing Address - Street 1:931 SALADO SLOUGH LN
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-1587
Mailing Address - Country:US
Mailing Address - Phone:832-788-3668
Mailing Address - Fax:
Practice Address - Street 1:10701 CORPORATE DR STE 340-111
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4096
Practice Address - Country:US
Practice Address - Phone:832-788-3668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty