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General NPI Number Information
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NPI Number | 1902616261
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Entity Type | Organization
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Legal Business Name | NIRVANA HEALTHCARE PLUS LLC
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 6 CARDINAL WAY STE 900
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City | SAINT LOUIS
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State | MO
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Zip | 63102-2807
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Country | US
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Telephone | 314-873-4659
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Fax | 636-246-0075
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Provider Business Mailing Address
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Address Line | 6 CARDINAL WAY STE 900
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City | SAINT LOUIS
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State | MO
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Zip | 63102-2807
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Country | US
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Telephone | 314-873-4659
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Fax | 636-246-0075
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TAYDREA MOORE
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Credential |
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Telephone | 314-874-7484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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