Provider Demographics
NPI:1417379074
Name:BUTLER, SAEVEON
Entity Type:Individual
Prefix:
First Name:SAEVEON
Middle Name:
Last Name:BUTLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6530 ANNIE OAKLEY DR
Mailing Address - Street 2:APT 1613
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2167
Mailing Address - Country:US
Mailing Address - Phone:702-338-8200
Mailing Address - Fax:
Practice Address - Street 1:6530 ANNIE OAKLEY DR
Practice Address - Street 2:APT 1613
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2167
Practice Address - Country:US
Practice Address - Phone:702-338-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor