Healthcare Provider Details

I. General information

NPI: 1164392999
Provider Name (Legal Business Name): A BUTTERFLY JOURNEY HOME CARE AGENCY,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2638 TWO NOTCH RD STE 240
COLUMBIA SC
29204-1454
US

IV. Provider business mailing address

2638 TWO NOTCH RD STE 240
COLUMBIA SC
29204-1454
US

V. Phone/Fax

Practice location:
  • Phone: 803-451-0201
  • Fax:
Mailing address:
  • Phone: 803-451-0201
  • 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 Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: TARSHIBA HAYNES
Title or Position: CEO
Credential:
Phone: 803-381-5440