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General NPI Number Information
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NPI Number | 1205760543
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Entity Type | Organization
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Legal Business Name | LOTUS ADDICTION RECOVERY AND WELLNESS
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 814 ELM ST STE 204
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City | MANCHESTER
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State | NH
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Zip | 03101-2130
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Country | US
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Telephone | 401-405-1840
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Fax |
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Provider Business Mailing Address
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Address Line | 814 ELM ST STE 204
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City | MANCHESTER
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State | NH
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Zip | 03101-2130
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Country | US
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Telephone | 508-361-1996
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. SHIVANI PEREIRA
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Credential |
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Telephone | 508-361-1996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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