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General NPI Number Information
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NPI Number | 1356642524
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Entity Type | Organization
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Legal Business Name | LOTUS CARE LLC
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 280 BONDALE AVE
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City | PONTIAC
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State | MI
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Zip | 48341-2720
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Country | US
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Telephone | 248-481-8943
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Fax | 248-481-8949
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Provider Business Mailing Address
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Address Line | PO BOX 252582
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48325-2582
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Country | US
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Telephone | 248-481-8943
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Fax | 248-481-8949
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. SHALON LEE
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Credential | LMSW
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Telephone | 248-481-8943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801077606
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801020098
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801067716
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801066342
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801034585
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801078772
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801003303
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License Number State | MI
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