Provider Demographics
NPI:1396504098
Name:LOTUS SEED THERAPIES
Entity type:Organization
Organization Name:LOTUS SEED THERAPIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRESSI
Authorized Official - Middle Name:INNANA
Authorized Official - Last Name:ALBEE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-415-1052
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:WILLIAMS
Mailing Address - State:OR
Mailing Address - Zip Code:97544-0445
Mailing Address - Country:US
Mailing Address - Phone:541-415-0436
Mailing Address - Fax:541-507-9123
Practice Address - Street 1:121 NE A ST STE A
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2111
Practice Address - Country:US
Practice Address - Phone:541-415-0436
Practice Address - Fax:541-507-9123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty