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General NPI Number Information
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NPI Number | 1174522700
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Entity Type | Organization
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Legal Business Name | LOTUS HEALTHCARE PARTNERS, INC
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 402 S PROSPECTORS RD STE G
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1618
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Country | US
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Telephone | 909-396-7440
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Fax | 909-396-7488
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Provider Business Mailing Address
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Address Line | 402 S PROSPECTORS RD STE G
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1618
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Country | US
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Telephone | 909-396-7440
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Fax | 909-396-7488
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOCELYN BUNOAN MANALO
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Credential | RN, MSN FNP
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Telephone | 909-396-7440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 980000959
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License Number State | CA
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