Provider Demographics
NPI:1952642621
Name:LOTUS GARDENS LLC
Entity Type:Organization
Organization Name:LOTUS GARDENS LLC
Other - Org Name:NEW HOPE ADULT DAY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GLADKOVITSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-503-4353
Mailing Address - Street 1:11 MIDDLE NECK RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2312
Mailing Address - Country:US
Mailing Address - Phone:718-503-4353
Mailing Address - Fax:
Practice Address - Street 1:3323 UNION ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3050
Practice Address - Country:US
Practice Address - Phone:718-503-4353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No305R00000XManaged Care OrganizationsPreferred Provider Organization