Healthcare Provider Details

I. General information

NPI: 1154660645
Provider Name (Legal Business Name): SOCIAL BUTTERFLY COMMUNITY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TODD CIR
WINGATE NC
28174-7782
US

IV. Provider business mailing address

200 TODD CIR
WINGATE NC
28174-7782
US

V. Phone/Fax

Practice location:
  • Phone: 980-722-5609
  • Fax:
Mailing address:
  • Phone: 980-722-5609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LEANN HUNTLEY
Title or Position: OWNER/CEO
Credential:
Phone: 980-722-5609