Provider Demographics
NPI:1265860902
Name:BUTLER, JOYCE
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 N 33RD TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66104-3874
Mailing Address - Country:US
Mailing Address - Phone:913-789-9785
Mailing Address - Fax:913-789-9785
Practice Address - Street 1:3515 N 33RD TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66104-3874
Practice Address - Country:US
Practice Address - Phone:913-789-9785
Practice Address - Fax:913-789-9785
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities