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General NPI Number Information
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NPI Number | 1316577091
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Entity Type | Organization
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Legal Business Name | LOTUS THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 01/22/2020
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Last Update Date | 06/18/2020
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Provider Practice Location Address
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Address Line | 2900 CHAMBLEE TUCKER RD
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City | ATLANTA
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State | GA
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Zip | 30341-4100
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Country | US
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Telephone | 833-902-0680
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Fax |
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Provider Business Mailing Address
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Address Line | 5024 STONEY POINT CIR
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City | STONE MOUNTAIN
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State | GA
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Zip | 30088-3735
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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 | OWNER
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Name | EDWINA TAYLOR FLOWERS
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Credential | LPC
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Telephone | 404-512-3244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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