Healthcare Provider Details

I. General information

NPI: 1538085238
Provider Name (Legal Business Name): ORANGE LOTUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 HOOK RD
XENIA OH
45385-9638
US

IV. Provider business mailing address

1209 HOOK RD
XENIA OH
45385-9638
US

V. Phone/Fax

Practice location:
  • Phone: 937-372-7424
  • Fax:
Mailing address:
  • Phone: 937-372-7424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS HENDERSON
Title or Position: OWNER
Credential:
Phone: 937-372-7424