Provider Demographics
NPI:1184415622
Name:LOTUS CENTER INC
Entity type:Organization
Organization Name:LOTUS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:PHYLLIS
Authorized Official - Last Name:WASEK
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:385-272-4292
Mailing Address - Street 1:4376 S 700 E STE 200
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3077
Mailing Address - Country:US
Mailing Address - Phone:385-272-4292
Mailing Address - Fax:866-855-3582
Practice Address - Street 1:4376 S 700 E STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-3077
Practice Address - Country:US
Practice Address - Phone:385-272-4292
Practice Address - Fax:866-855-3582
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOTUS CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health