Provider Demographics
NPI:1821852658
Name:LOTUS CENTER FOR WOMEN'S MENTAL HEALTH AND PSYCHIATRY
Entity Type:Organization
Organization Name:LOTUS CENTER FOR WOMEN'S MENTAL HEALTH AND PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:D'AMORE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:309-396-6425
Mailing Address - Street 1:3833 N SHERIDAN RD STE B
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-7134
Mailing Address - Country:US
Mailing Address - Phone:309-396-6425
Mailing Address - Fax:309-326-4413
Practice Address - Street 1:3833 N SHERIDAN RD STE B
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-7134
Practice Address - Country:US
Practice Address - Phone:309-396-6425
Practice Address - Fax:309-326-4413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty