Provider Demographics
NPI:1477108017
Name:NIRVANA BEHAVIORAL SOLUTIONS,LLC
Entity Type:Organization
Organization Name:NIRVANA BEHAVIORAL SOLUTIONS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING CONTACT
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-301-8322
Mailing Address - Street 1:7111 HARWIN DR STE 130
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2130
Mailing Address - Country:US
Mailing Address - Phone:832-301-3822
Mailing Address - Fax:855-308-8322
Practice Address - Street 1:7111 HARWIN DR STE 130
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2130
Practice Address - Country:US
Practice Address - Phone:832-301-3822
Practice Address - Fax:855-308-8322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1376046136OtherNPI