| Blu Lotus Llc | |
|
4560 Huntington Dr Gastonia NC 28056-8476 | |
| (704) 953-2825 | |
| Not Available |
| Full Name | Blu Lotus Llc |
|---|---|
| Speciality | Case Management |
| Location | 4560 Huntington Dr, Gastonia, North Carolina |
| Authorized Official Name and Position | Sherrell Erwin (CEO) |
| Authorized Official Contact | 7049532825 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blu Lotus Llc 1819 Sardis Rd N Ste 350 Charlotte NC 28270-2472 Ph: (704) 755-6333 | Blu Lotus Llc 4560 Huntington Dr Gastonia NC 28056-8476 Ph: (704) 953-2825 |
| NPI Number | 1669258067 |
|---|---|
| Provider Enumeration Date | 09/01/2023 |
| Last Update Date | 12/01/2023 |
| Certification Date | 12/01/2023 |
| Medicare PECOS PAC ID | 9739609611 |
|---|---|
| Medicare Enrollment ID | O20250221002144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669258067 | NPI | - | NPPES |
| Provider Name | Robin Stitt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881257582 PECOS PAC ID: 0749626992 Enrollment ID: I20240310000136 |
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