Organization
BLU LOTUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRELL ERWIN RN CCM (CEO)
(704) 953-2825
Entity
Organization
Contact information
Practice address
4560 HUNTINGTON DR, GASTONIA, NC 28056-8476
(704) 953-2825
Mailing address
1819 SARDIS RD N STE 350, CHARLOTTE, NC 28270-2472
(704) 755-6333
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
09/01/2023
Last updated
12/01/2023
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