Provider Demographics
NPI:1477139509
Name:GOLDEN BUTTERFLY HEALTH LLC
Entity Type:Organization
Organization Name:GOLDEN BUTTERFLY HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-215-0413
Mailing Address - Street 1:17002 COTTONWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-4135
Mailing Address - Country:US
Mailing Address - Phone:402-215-0413
Mailing Address - Fax:
Practice Address - Street 1:17002 COTTONWOOD CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-4135
Practice Address - Country:US
Practice Address - Phone:402-215-0413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE37122651Medicaid