Organization
LOTUS MENTAL HEALTH SYSTEM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKAIL BASS LCSW (OWNER)
(708) 646-4467
Entity
Organization
Contact information
Practice address
21604 DOGWOOD RD, MATTESON, IL 60443-4400
(815) 393-9850
(815) 205-4812
Mailing address
21604 DOGWOOD RD, MATTESON, IL 60443-4400
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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