Healthcare Provider Details

I. General information

NPI: 1750626255
Provider Name (Legal Business Name): NIRVANA ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2012
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 OAK TREE RD
EDISON NJ
08820-2012
US

IV. Provider business mailing address

2050 OAK TREE RD
EDISON NJ
08820-2012
US

V. Phone/Fax

Practice location:
  • Phone: 732-991-8527
  • Fax: 732-947-3001
Mailing address:
  • Phone: 732-991-8527
  • Fax: 732-947-3001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: VISHAL PATEL
Title or Position: PARTNER
Credential:
Phone: 732-991-8527