- Enrollment id
- O20050502000183
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1750338562
- Multiple npi flag
- N
- Ccn
- 673175
- Associate id
- 7517906399
- Organization name
- LOTUS HOME HEALTHCARE SERVICES, PC
- Doing business as name
- LOTUS HOME HEALTHCARE SERVICES PC
- Incorporation date
- 2003-12-01
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 17330 PRESTON RD
- Address line 2
- STE 200D
- City
- DALLAS
- State
- TX
- Zip code
- 752526106