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General NPI Number Information
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NPI Number | 1356771992
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Entity Type | Organization
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Legal Business Name | LOTUS HOUSE, LLC
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Dates
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Enumeration Date | 11/18/2013
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Last Update Date | 11/18/2013
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Provider Practice Location Address
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Address Line | 550 EARL GARRETT ST STE 201
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City | KERRVILLE
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State | TX
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Zip | 78028-4577
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Country | US
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Telephone | 830-481-7406
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Fax |
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Provider Business Mailing Address
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Address Line | 550 EARL GARRETT ST STE 201
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City | KERRVILLE
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State | TX
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Zip | 78028-4577
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Country | US
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Telephone | 830-481-7406
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Fax |
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Authorized Official
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Title or Position | OWNER/ PEER RECOVERY SUPPORT SPECIA
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Name | CATHERINE NICOLE SAURAGE
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Credential | PRS
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Telephone | 830-481-7406
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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 | NULL
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