Provider Demographics
NPI:1679659429
Name:NIRVANA HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:NIRVANA HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-647-5008
Mailing Address - Street 1:220 E CENTRAL PARKWAY
Mailing Address - Street 2:SUITE 2070
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701
Mailing Address - Country:US
Mailing Address - Phone:407-647-5008
Mailing Address - Fax:407-647-5299
Practice Address - Street 1:220 E CENTRAL PARKWAY
Practice Address - Street 2:SUITE 2070
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-647-5008
Practice Address - Fax:407-647-5299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21347096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107616Medicare UPIN