Provider Demographics
NPI:1366263477
Name:NIRVANA CARE ADULT FAMILY HOME LLC
Entity type:Organization
Organization Name:NIRVANA CARE ADULT FAMILY HOME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:WAITHERA
Authorized Official - Last Name:KAMAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-503-8811
Mailing Address - Street 1:9005 CECILE CT SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-5976
Mailing Address - Country:US
Mailing Address - Phone:206-503-8811
Mailing Address - Fax:206-770-6295
Practice Address - Street 1:9005 CECILE CT SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-5976
Practice Address - Country:US
Practice Address - Phone:206-565-6656
Practice Address - Fax:206-770-6295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse