Organization
LOTUS PARK CARE CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLES GEORGE OSMAN (ADMINISTRATOR)
(801) 389-6555
Entity
Organization
Contact information
Practice address
2639 W 3520 S, WEST HAVEN, UT 84401
(801) 389-6555
Mailing address
2639 W 3520 S, WEST HAVEN, UT 84401-8529
(801) 389-6555
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2012-A11-106306
UT
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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