Organization
NANA HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON JIMENO (CEO)
(305) 975-4151
Entity
Organization
Contact information
Practice address
2053 N UNIVERSITY DR, SUNRISE, FL 33322-3936
(305) 975-4151
Mailing address
2053 N UNIVERSITY DR, SUNRISE, FL 33322-3936
(305) 975-4151
(954) 302-2227
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121748900
—
FL
Enumeration date
08/16/2023
Last updated
04/08/2026
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