Provider Demographics
NPI:1407574122
Name:BUTTERFLY COMMUNITY CENTER CORP
Entity Type:Organization
Organization Name:BUTTERFLY COMMUNITY CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:SUSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-921-7861
Mailing Address - Street 1:1645 PALM BEACH LAKES BLVD STE 1200 OFFICE 19
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401
Mailing Address - Country:US
Mailing Address - Phone:561-921-7861
Mailing Address - Fax:
Practice Address - Street 1:1645 PALM BEACH LAKES BLVD STE 1200 OFFICE 19
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401
Practice Address - Country:US
Practice Address - Phone:561-921-7861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty