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General NPI Number Information
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NPI Number | 1548080641
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Entity Type | Organization
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Legal Business Name | LOTUS ADULT DAY HEALTH CENTER, LLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 14 ALLSTON ST APT 1
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City | REVERE
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State | MA
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Zip | 02151-5271
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Country | US
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Telephone | 781-690-6797
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Fax |
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Provider Business Mailing Address
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Address Line | 14 ALLSTON ST APT 1
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City | REVERE
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State | MA
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Zip | 02151-5271
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Country | US
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Telephone | 781-690-6797
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/MEMBER
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Name | JOSE AGUILAR
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Credential | FNP-C
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Telephone | 781-690-6797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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