Healthcare Provider Details

I. General information

NPI: 1932918026
Provider Name (Legal Business Name): BUTTERFLY HAVEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 SEMINOLE TRL
DANVILLE VA
24540-1871
US

IV. Provider business mailing address

208 SEMINOLE TRL
DANVILLE VA
24540-1871
US

V. Phone/Fax

Practice location:
  • Phone: 434-429-8543
  • Fax: 434-425-0843
Mailing address:
  • Phone: 434-429-8543
  • Fax: 434-425-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TOMI LEE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: QMHP
Phone: 434-429-8543