Provider Demographics
NPI:1407323264
Name:THE LOTUS CENTER, INC.
Entity Type:Organization
Organization Name:THE LOTUS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:PRISCILLA
Authorized Official - Last Name:CHATELAIN-GRESS
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:218-284-1800
Mailing Address - Street 1:1401 8TH ST S STE 3
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-3658
Mailing Address - Country:US
Mailing Address - Phone:218-284-1803
Mailing Address - Fax:218-600-5484
Practice Address - Street 1:200 5TH ST S STE 105
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-2768
Practice Address - Country:US
Practice Address - Phone:218-284-1800
Practice Address - Fax:218-284-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-30
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1478390Medicaid
MN1090378Medicaid