NPI 1073188629
Nirvana Squared LLC
Practice location
- Address
- 1027 E Seldon Ln, Phoenix, AZ 85020-3259
- Phone
- (301) 366-5675
- Mailing address
- 7426 E Stetson Dr Unit 3017e, Scottsdale, AZ 85251-3877
Authorised official
- Name
- Travis Plummer
- Title
- Ceo
- Phone
- (301) 366-5675
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1073188629
- Entity type
- Organization
- NPI issued
- 26 May 2021
- Record last updated
- 26 May 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.