Organization
LOTUS MEDICAL GROUP LLC
Active
Other names
MENTAL WELLNESS & BEHAVIORAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
QUENNIE MANUEL (CEO)
(702) 686-8180
Entity
Organization
Contact information
Practice address
825 SOUTH MAIN STREET BOX#393, #393, TONOPAH, NV 89049-2523
(775) 382-2000
Mailing address
5625 LOSEE RD, NORTH LAS VEGAS, NV 89081-2523
(702) 686-8180
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
106S00000X
Behavior Technician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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