Provider Demographics
NPI:1861735243
Name:TRANQUILITY DAY SPA, INC.
Entity type:Organization
Organization Name:TRANQUILITY DAY SPA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-229-1315
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:DARDANELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72834-0156
Mailing Address - Country:US
Mailing Address - Phone:479-229-1315
Mailing Address - Fax:
Practice Address - Street 1:27403 N STATE HWY 27 SOUTH
Practice Address - Street 2:SUITE B
Practice Address - City:POTTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72834
Practice Address - Country:US
Practice Address - Phone:479-229-1315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service