Organization
LOTUS SPRING LLC
Active
Organization
LOTUS SPRING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN HOM LCSW (CLINICAL SOCIAL WORKER)
(201) 525-1625
Entity
Organization
Contact information
Practice address
307 PROSPECT AVE APT 14E, HACKENSACK, NJ 07601-2555
(201) 525-1625
Mailing address
307 PROSPECT AVE APT 14E, HACKENSACK, NJ 07601-2555
(201) 525-1625
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SC
NJ
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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