Provider Demographics
NPI:1780204222
Name:LOTUS KINECTS, INC.
Entity Type:Organization
Organization Name:LOTUS KINECTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAMONA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-383-2623
Mailing Address - Street 1:1185 NW 88TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-2545
Mailing Address - Country:US
Mailing Address - Phone:386-383-2628
Mailing Address - Fax:
Practice Address - Street 1:1866 NW 51ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-3727
Practice Address - Country:US
Practice Address - Phone:786-383-2628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-24
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health