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General NPI Number Information
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NPI Number | 1558233155
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Entity Type | Organization
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Legal Business Name | NIRVANA CARE LLC
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1250 S SR 15A
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City | DELAND
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State | FL
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Zip | 32720-7257
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Country | US
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Telephone | 386-561-3183
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 S SR 15A
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City | DELAND
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State | FL
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Zip | 32720-7257
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Country | US
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Telephone | 386-561-3183
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Fax |
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Authorized Official
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Title or Position | CNA
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Name | LASASHA C WASHINGTON
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Credential |
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Telephone | 386-299-2948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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