Provider Demographics
NPI:1083298996
Name:LOTUS ROYALTY HEALTH CARE
Entity Type:Organization
Organization Name:LOTUS ROYALTY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-685-3470
Mailing Address - Street 1:7070 W CAMP WISDOM RD APT 514
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75236-5614
Mailing Address - Country:US
Mailing Address - Phone:469-685-3470
Mailing Address - Fax:
Practice Address - Street 1:7070 W CAMP WISDOM RD APT 514
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75236-5614
Practice Address - Country:US
Practice Address - Phone:469-685-3470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home