Provider Demographics
NPI:1205578671
Name:GOLDEN LOTUS HOME HEALTH LLC
Entity type:Organization
Organization Name:GOLDEN LOTUS HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:QUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-538-8023
Mailing Address - Street 1:9840 MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-3909
Mailing Address - Country:US
Mailing Address - Phone:571-538-8023
Mailing Address - Fax:571-503-9998
Practice Address - Street 1:9840 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3909
Practice Address - Country:US
Practice Address - Phone:571-538-8023
Practice Address - Fax:571-503-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care