Organization
NIRVANA RECOVERY LLC
Active
Organization
NIRVANA RECOVERY LLC
Active
Parent organization
NIRVANA RECOVERY LLC
Other names
Nirvana Residential Treatment
Organization subpart
Yes
Provider details
NPI number
Legal business name
NIRVANA RECOVERY LLC
Authorized official
MICHAEL TRYCHON (CEO)
(602) 471-2152
Entity
Organization
Contact information
Practice address
15852 N 17TH ST, PHOENIX, AZ 85022-3365
(602) 662-2287
(480) 427-6996
Mailing address
21725 N 20TH AVE, PHOENIX, AZ 85027-2640
(480) 764-2335
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/11/2024
Last updated
01/27/2026
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