Provider Demographics
NPI:1992167118
Name:LOTUS CENTER INC
Entity type:Organization
Organization Name:LOTUS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTERS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, DNP
Authorized Official - Phone:801-824-2185
Mailing Address - Street 1:2204 E 3715 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-3338
Mailing Address - Country:US
Mailing Address - Phone:801-824-2185
Mailing Address - Fax:
Practice Address - Street 1:348 E 4500 S
Practice Address - Street 2:SUITE 360
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-3906
Practice Address - Country:US
Practice Address - Phone:385-272-4292
Practice Address - Fax:866-855-3582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-26
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2001474405251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000094047Medicare PIN
UT1699041640Medicaid