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General NPI Number Information
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NPI Number | 1912330176
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL BUTTERFLIES MENTORING PROGRAM, INC.
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 08/12/2013
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Provider Practice Location Address
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Address Line | 2448 VINEYARD CIR
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City | SANFORD
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State | FL
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Zip | 32771-6844
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Country | US
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Telephone | 850-443-3088
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Fax |
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Provider Business Mailing Address
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Address Line | 2448 VINEYARD CIR
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City | SANFORD
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State | FL
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Zip | 32771-6844
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Country | US
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Telephone | 850-443-3088
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Fax |
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Authorized Official
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Title or Position | FOUNDER/EXECUTIVE DIRECTOR
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Name | MRS. LYNDORA FRAZIER
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Credential |
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Telephone | 850-443-3088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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