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General NPI Number Information
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NPI Number | 1659863967
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Entity Type | Organization
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Legal Business Name | RISING LOTUS THERAPY SERVICES, PLLC
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 1401 MALVERN AVE STE 200A
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City | HOT SPRINGS
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State | AR
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Zip | 71901-6371
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Country | US
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Telephone | 501-318-8190
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Fax | 844-799-3414
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Provider Business Mailing Address
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Address Line | 1401 MALVERN AVE STE 200A
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City | HOT SPRINGS
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State | AR
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Zip | 71901-6371
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Country | US
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Telephone | 501-318-8190
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Fax | 844-799-3414
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Authorized Official
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Title or Position | OWNER
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Name | LESLIE J CHESSHIR
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Credential | LCSW
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Telephone | 501-318-8190
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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 | 3521-C
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License Number State | AR
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