Organization
THE BLUE LOTUS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTIANNE M LYSNE PH.D. (OWNER)
(218) 770-0593
Entity
Organization
Contact information
Practice address
225 W CAVOUR AVE STE C, FERGUS FALLS, MN 56537-2140
(218) 770-0593
Mailing address
31255 153RD AVE, ELIZABETH, MN 56533-9562
(218) 770-0593
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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