Provider Demographics
NPI:1558233155
Name:NIRVANA CARE LLC
Entity type:Organization
Organization Name:NIRVANA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:
Authorized Official - First Name:LASASHA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-299-2948
Mailing Address - Street 1:1250 S SR 15A
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-7257
Mailing Address - Country:US
Mailing Address - Phone:386-561-3183
Mailing Address - Fax:
Practice Address - Street 1:1250 S SR 15A
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-7257
Practice Address - Country:US
Practice Address - Phone:386-561-3183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty