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General NPI Number Information
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NPI Number | 1255050381
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Entity Type | Organization
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Legal Business Name | LOTUS LIFE TOTAL WELLNESS INC.
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 44 PELHAM DR
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City | COATESVILLE
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State | PA
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Zip | 19320-1951
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Country | US
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Telephone | 484-784-6272
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Fax |
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Provider Business Mailing Address
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Address Line | 44 PELHAM DR
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City | COATESVILLE
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State | PA
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Zip | 19320-1951
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CEO
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Name | BRIANA BEVERLY
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Credential | MS, NCC, CBIS
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Telephone | 443-934-5019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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