Provider Demographics
NPI:1285414433
Name:LOTUS COMMUNITY LIVING SUPPORTS INC.
Entity type:Organization
Organization Name:LOTUS COMMUNITY LIVING SUPPORTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXCUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EURICE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-689-2935
Mailing Address - Street 1:481 N MAIN ST STE 208
Mailing Address - Street 2:
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-1115
Mailing Address - Country:US
Mailing Address - Phone:810-689-2935
Mailing Address - Fax:
Practice Address - Street 1:3205 BRIDLE PATH
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1201
Practice Address - Country:US
Practice Address - Phone:810-337-1275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOTUS COMMUNITY LIVING SUPPORTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities