| Green Lotus Creative Healing Center Llc | |
|
49 Kenwood St Berlin CT 06037-2016 | |
| (860) 470-4304 | |
| (860) 516-8286 |
| Full Name | Green Lotus Creative Healing Center Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 49 Kenwood St, Berlin, Connecticut |
| Authorized Official Name and Position | Brittany Quinn (QWNER) |
| Authorized Official Contact | 8604704304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Lotus Creative Healing Center Llc 49 Kenwood St Berlin CT 06037-2016 Ph: (860) 470-4304 | Green Lotus Creative Healing Center Llc 49 Kenwood St Berlin CT 06037-2016 Ph: (860) 470-4304 |
| NPI Number | 1578078739 |
|---|---|
| Provider Enumeration Date | 12/11/2017 |
| Last Update Date | 09/13/2021 |
| Certification Date | 09/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578078739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 3209 (Connecticut) | Primary |
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