| Organization Name: | LOTUS BEHAVIORAL HEALTH AND WELLNESS, LLC |
| NPI Number: | 1033515796 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MEGAN ROEHRIG TONDU (OWNER) |
| Mailing Address: | 1910 1st St Ste 302 Highland Park |
| State: | IL US |
| Postal Code: | 600353146 |
| Phone Number: | 3124206427 |
| Fax Number: | |
| NPI Enumeration Date: | 11/07/2014 |
| NPI Last Update Date: | 11/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0850X |
| License Number: | 071.007970 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Mental Health |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |