Provider Demographics
NPI:1356771992
Name:LOTUS HOUSE, LLC
Entity type:Organization
Organization Name:LOTUS HOUSE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PEER RECOVERY SUPPORT SPECIA
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:SAURAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PRS
Authorized Official - Phone:830-481-7406
Mailing Address - Street 1:550 EARL GARRETT ST STE 201
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-4577
Mailing Address - Country:US
Mailing Address - Phone:830-481-7406
Mailing Address - Fax:
Practice Address - Street 1:550 EARL GARRETT ST STE 201
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4577
Practice Address - Country:US
Practice Address - Phone:830-481-7406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization