Organization
TRANQUIL COMMUNITY CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINSHASSA E BROWN (OWNER)
(419) 360-9958
Entity
Organization
Contact information
Practice address
16000 W 9 MILE RD STE 420C, SOUTHFIELD, MI 48075-4839
(248) 557-0484
Mailing address
16000 W 9 MILE RD STE 420C, SOUTHFIELD, MI 48075-4839
(248) 557-0484
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MI
Enumeration date
04/20/2018
Last updated
06/11/2019
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