TRANQUILITY PCH LLC NPI 1427336346

NPI Information

NPI: 1427336346
Provider Name: TRANQUILITY PCH, LLC
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
3440 RAINBOW DR
DECATUR, GA
ZIP 30034
Phone: (404) 593-6386
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TRANQUILITY PCH, LLC is an intermediate care facility mentally retarded in Decatur, GA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. TRANQUILITY PCH, LLC NPI is 1427336346. The provider is registered as an organization entity type.

The provider's business location address is:

3440 RAINBOW DR
DECATUR, GA
ZIP 30034-807
Phone: (404) 593-6386

The provider's authorized official is Sheryl Wright .
The authorized official title is Ceo and has the following contact phone number (404) 593-6386.

The enumeration date for this NPI number is 7/26/2011 and was last updated on 7/26/2011.

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	315P00000X	Intermediate Care Facility, Intellectual Disabilities		044-01-737-2	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	291733345A	MEDICAID	GEORGIA

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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