MEDICARE: FLOWING LOTUS CENTER, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	251S00000X	Community/Behavioral Health Agency
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1841067956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOWING LOTUS CENTER, LLC.

Provider Business Mailing Address
First Line	:	7181 N HUALAPAI WAY STE 943
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-1115
Country	:	US
Telephone Number	:	725-867-9374
Fax Number	:

Provider Business Practice Location Address
First Line	:	10213 MADISON AVENUE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-5226
Country	:	US
Telephone Number	:	725-867-9374
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TOSHIA SHAW
Credential	:	LCSW
Telephone Number	:	725-867-9374

Provider Enumeration Date	:	12/08/2023
Last Update Date	:	12/08/2023

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