TRANQUILITY BEHAVIORAL TELEHEALTH LLC NPI 1306488572

NPI Information

NPI: 1306488572
Provider Name: TRANQUILITY BEHAVIORAL TELEHEALTH LLC

Doing Business As: GLACIER MENTAL AND FAMILY HEALTH SOLUTIONS

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
17051 MERCY DR STE 204
EAGLE RIVER, AK
ZIP 99577
Phone: (907) 696-0096
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TRANQUILITY BEHAVIORAL TELEHEALTH LLC is a psychiatric/mental health nurse practitioner in Eagle River, AK. TRANQUILITY BEHAVIORAL TELEHEALTH LLC NPI is 1306488572. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Glacier Mental And Family Health Solutions.

The provider's business location address is:

17051 MERCY DR STE 204
EAGLE RIVER, AK
ZIP 99577-630
Phone: (907) 696-0096
Fax: (949) 577-4808

The provider's authorized official is Shannon R Davis .
The authorized official title is Owner and has the following contact phone number (907) 696-0096.

The CLIA number assigned to this NPI record is 02D2232591 - other - nurse practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/9/2019 and was last updated on 12/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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