Provider Demographics
NPI:1346591971
Name:BLUE LOTUS HEALTH & ACUPUNCTURE
Entity Type:Organization
Organization Name:BLUE LOTUS HEALTH & ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAREAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-533-0914
Mailing Address - Street 1:3720 WILLOW RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-1562
Mailing Address - Country:US
Mailing Address - Phone:859-533-0914
Mailing Address - Fax:
Practice Address - Street 1:3720 WILLOW RIDGE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40514-1562
Practice Address - Country:US
Practice Address - Phone:859-533-0914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-22
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAC072171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty