Nirvana Residential Services LLC

NPI #1194225037 in Forest, Virginia

Provider Information

NPI Number: 1194225037
Entity Type: Organization
Organization Name: Nirvana Residential Services LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 16, 2018
Last Updated: Feb 16, 2018

Practice Location

Address: 1325 SMARTVIEW LN
City: Forest
State: Virginia
ZIP Code: 24551-1099
Phone: (434) 237-7717

Authorized Official

Name: STACEY BROWN
Title: DIRECTOR
Phone: (434) 237-7717

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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