# NIRVANA SQUARED LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073188629
- **Authorized official:** MR. TRAVIS PLUMMER (CEO)
- **Authorized official phone:** (301) 366-5675

## Contact information

- **Practice address:** 1027 E SELDON LN, PHOENIX, AZ 85020-3259
- **Practice address phone:** (301) 366-5675
- **Mailing address:** 7426 E STETSON DR UNIT 3017E, SCOTTSDALE, AZ 85251-3877
- **Mailing address phone:** (301) 366-5675

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/26/2021
- **Last updated:** 05/26/2021