Provider Demographics
NPI:1447826508
Name:TRANQUIL BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:TRANQUIL BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO - OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:410-684-9432
Mailing Address - Street 1:1600 ORLANDO RD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5322
Mailing Address - Country:US
Mailing Address - Phone:443-542-3529
Mailing Address - Fax:240-770-0436
Practice Address - Street 1:1600 ORLANDO RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-5322
Practice Address - Country:US
Practice Address - Phone:443-542-3529
Practice Address - Fax:240-770-0436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health