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General NPI Number Information
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NPI Number | 1093291726
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Entity Type | Organization
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Legal Business Name | LOTUS THE CENTER FOR BEHAVIORAL HEALTH AND WELLNESS
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 401 15TH ST SE UNIT 100-C
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City | WASHINGTON
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State | DC
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Zip | 20003-3042
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Country | US
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Telephone | 202-370-6872
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Fax |
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Provider Business Mailing Address
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Address Line | 401 15TH ST SE UNIT 100-C
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City | WASHINGTON
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State | DC
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Zip | 20003-3042
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Country | US
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Telephone | 202-370-6872
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS MALENA A BANKS
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Credential | MD
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Telephone | 202-370-6872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0301X
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Taxonomy Name | Brain Injury Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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