Healthcare Provider Details
I. General information
NPI: 1063206928
Provider Name (Legal Business Name): BUTTERFLY HAVEN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2025
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
140 BUSHY HILL RD
DEEP RIVER CT
06417-1561
US
IV. Provider business mailing address
140 BUSHY HILL RD
DEEP RIVER CT
06417-1561
US
V. Phone/Fax
- Phone: 860-391-9878
- Fax:
- Phone: 860-391-9878
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2055X |
| Taxonomy | Child Mental Illness Respite Care |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2060X |
| Taxonomy | Child Intellectual and/or Developmental Disabilities Respite Care |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2065X |
| Taxonomy | Child Physical Disabilities Respite Care |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BOBBIANNE
ELIZABETH
STAMBAUGH
Title or Position: CEO
Credential: CNA, RBT
Phone: 860-391-9878