Tranquil Shores LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

06-52-AD-495901 Issued in FL

Legal business name

TRANQUIL SHORES LLC

Practice address

4300 Duhme Rd FL 2
Madeira Beach, FL 33708-2876

Phone

(727) 391-7001

Fax

(727) 391-3125

NPI assigned

Sep 7, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Chad Johnson

Title

Ceo

Phone

(727) 391-7001

Specialties & licenses 5

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1730496126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 DUHME RD FL 2",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082876",
            "telephone_number": "727-391-7001",
            "fax_number": "727-391-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 DUHME RD FL 2",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082876",
            "telephone_number": "727-391-7001",
            "fax_number": "727-391-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANQUIL SHORES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-07",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "727-391-7001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "06-52-AD-495901",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "06-52-AD-495901",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": "06-52-AD-495901",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "FL",
            "license": "06-52-AD-495901",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": "06-52-AD-495901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Ben Skerker, MD
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• Joshua Daniel Whitmer, PHARMD
• Michal Ziaja, RN

• Substance Use Disorder Rehabilitation Clinic/Center in Madeira Beach, FL
• Providers in Madeira Beach, FL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.