Organization · Type 2 NPI

Nirvana Recovery LLC

Substance Abuse Rehabilitation Facility · Phoenix, AZ

NPI number 1669289880 Active

Practice location

15852 N 17th St
Phoenix, AZ 85022-3365

Call (602) 662-2287 Map

Fax (480) 427-6996

Mailing address

21725 N 20th Ave
Phoenix, AZ 85027-2640

Specialties and licenses

Taxonomy	Code	License
Substance Use Disorder Rehabilitation Clinic/Center	261QR0405X	None listed
Substance Abuse Rehabilitation Facility Primary	324500000X	None listed

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

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NPI record

NPI: 1669289880
Entity type: Organization (Type 2)
Issued: Dec 11, 2024
Last updated: Jan 27, 2026
Status: Active
Subpart: Yes of Nirvana Recovery LLC

Other names

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Nirvana Residential Treatment · doing business as
Nirvana Residential Treatment · doing business as

Authorized official

Michael Trychon
CEO
(602) 471-2152

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1669289880

Nirvana Recovery LLC's National Provider Identifier is 1669289880, issued on Dec 11, 2024. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Phoenix, AZ. The record was last updated on Jan 27, 2026.