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General NPI Number Information
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NPI Number | 1790030021
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Entity Type | Organization
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Legal Business Name | BUTTERFLY EFFECTS
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Dates
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Enumeration Date | 07/24/2012
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Last Update Date | 07/24/2012
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Provider Practice Location Address
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Address Line | 640 GREEN VALLEY DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-4628
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Country | US
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Telephone | 175-749-5830
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Fax |
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Provider Business Mailing Address
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Address Line | 2708 NE 14TH ST SUITE 5
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City | POMPANO BEACH
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State | FL
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Zip | 33062-3565
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Country | US
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Telephone | 188-888-0927
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Fax |
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Authorized Official
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Title or Position | RECRUITER
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Name | LIZ MARTINEZ
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Credential |
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Telephone | 18888809270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | VA
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