Provider Demographics
NPI:1831852102
Name:TRANQUILITY BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:TRANQUILITY BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:YURENA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, FNP-C
Authorized Official - Phone:210-573-3143
Mailing Address - Street 1:2955 NEW CENTER PT # 1054
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-2806
Mailing Address - Country:US
Mailing Address - Phone:210-573-3143
Mailing Address - Fax:
Practice Address - Street 1:2955 NEW CENTER PT # 1054
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80922-2806
Practice Address - Country:US
Practice Address - Phone:210-573-3143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty