| Lotus Spring Llc | |
|
307 Prospect Ave Apt 14e Hackensack NJ 07601-2555 | |
| (201) 525-1625 | |
| Not Available |
| Full Name | Lotus Spring Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 307 Prospect Ave Apt 14e, Hackensack, New Jersey |
| Authorized Official Name and Position | Maryann Hom (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2015251625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Spring Llc 307 Prospect Ave Apt 14e Hackensack NJ 07601-2555 Ph: (201) 525-1625 | Lotus Spring Llc 307 Prospect Ave Apt 14e Hackensack NJ 07601-2555 Ph: (201) 525-1625 |
| NPI Number | 1013419704 |
|---|---|
| Provider Enumeration Date | 03/08/2018 |
| Last Update Date | 03/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013419704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 44SC (New Jersey) | Primary |
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