Provider Demographics
NPI:1912709429
Name:NIRVANA GARDENS ASSISTED LIVING LLC
Entity type:Organization
Organization Name:NIRVANA GARDENS ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GABUZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-925-6629
Mailing Address - Street 1:15801 HART ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-5013
Mailing Address - Country:US
Mailing Address - Phone:323-870-7077
Mailing Address - Fax:818-475-5224
Practice Address - Street 1:15801 HART ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-5013
Practice Address - Country:US
Practice Address - Phone:323-870-7077
Practice Address - Fax:818-475-5224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility