Provider Demographics
NPI:1578272357
Name:LOTUS ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:LOTUS ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NOVI
Authorized Official - Middle Name:E
Authorized Official - Last Name:OEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-218-4906
Mailing Address - Street 1:4633 S IVORY CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1407
Mailing Address - Country:US
Mailing Address - Phone:720-218-4906
Mailing Address - Fax:
Practice Address - Street 1:4633 S IVORY CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1407
Practice Address - Country:US
Practice Address - Phone:720-218-4906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility