Provider Demographics
NPI:1922683432
Name:LOTUS ABA SERVICES
Entity type:Organization
Organization Name:LOTUS ABA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:856-381-4622
Mailing Address - Street 1:1104 ROUTE 130 N STE J
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-3032
Mailing Address - Country:US
Mailing Address - Phone:856-381-4622
Mailing Address - Fax:
Practice Address - Street 1:1104 ROUTE 130 N STE J
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-3032
Practice Address - Country:US
Practice Address - Phone:856-381-4622
Practice Address - Fax:856-389-5475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No251S00000XAgenciesCommunity/Behavioral Health