Healthcare Provider Details
I. General information
NPI: 1093646978
Provider Name (Legal Business Name): BUTTERFLY TRANSITION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11A PRIVATE DRIVE 1525
HERNANDEZ NM
87537-9711
US
IV. Provider business mailing address
PO BOX 111
ESPANOLA NM
87532-0111
US
V. Phone/Fax
- Phone: 505-279-1801
- Fax: 505-638-8999
- Phone: 505-279-1801
- Fax: 505-638-8999
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARGARET
MARY
TRIVINO
Title or Position: PMHNP
Credential: NP
Phone: 505-279-1801