Organization
HAZEL'S TRANQUILITY PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KESHA PATRICE WILLIAMS (CEO)
(707) 332-7825
Entity
Organization
Contact information
Practice address
125 HUMPHREY LN, VALLEJO, CA 94591-7234
(707) 332-7825
Mailing address
4825 FERNWOOD CT, FAIRFIELD, CA 94534-6856
(707) 332-7825
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
02/20/2024
Last updated
11/17/2024
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