Organization Active NPI

Tranquility Minnesota

Doing business as BetterHealth

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eden Prairie, MN
National Provider Identifier
1164262408
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TRANQUILITY MINNESOTA
Doing business as
BetterHealth
Practice address
6385 Old Shady Oak Rd Ste 250
Eden Prairie, MN 55344-7705
Phone
(612) 404-9640
Fax
(612) 238-0100
NPI assigned
May 24, 2024
Last updated
May 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Emmanuel Sumo Miantona
Title
Program Director
Phone
(612) 404-9640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

6385 Old Shady Oak Rd Ste 250
Eden Prairie, MN 55344-7705

Mailing address

6385 Old Shady Oak Rd Ste 250
C/O Betterhealth
Eden Prairie, MN 55344-7705
Phone (612) 404-9640

Other names 1

  • BetterHealth Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1164262408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6385 OLD SHADY OAK RD STE 250",
            "address_2": "C/O BETTERHEALTH",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447705",
            "telephone_number": "612-404-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6385 OLD SHADY OAK RD STE 250",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447705",
            "telephone_number": "612-404-9640",
            "fax_number": "612-238-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANQUILITY MINNESOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "MIANTONA",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_middle_name": "SUMO",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "612-404-9640",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BetterHealth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.