Provider Demographics
NPI:1710630926
Name:LOTUS CARE LLC
Entity Type:Organization
Organization Name:LOTUS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALOYS
Authorized Official - Middle Name:PAGAL
Authorized Official - Last Name:ONGLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-280-7702
Mailing Address - Street 1:19971 FEBRUARY ST
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55309-4800
Mailing Address - Country:US
Mailing Address - Phone:651-280-7702
Mailing Address - Fax:612-435-0262
Practice Address - Street 1:14000 SUNFISH LAKE BLVD NW STE 206
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-4760
Practice Address - Country:US
Practice Address - Phone:224-622-3408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN38723OtherHOME CARE