Provider Demographics
NPI:1508629783
Name:LOTUS HOPE & HEALING, LLC
Entity Type:Organization
Organization Name:LOTUS HOPE & HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:651-283-7656
Mailing Address - Street 1:1925 PHEASANT RUN DR NE
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-3208
Mailing Address - Country:US
Mailing Address - Phone:651-283-7656
Mailing Address - Fax:
Practice Address - Street 1:1850 AUSTIN RD STE 100
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-4498
Practice Address - Country:US
Practice Address - Phone:507-676-5932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)