Provider Demographics
NPI:1659677482
Name:BUTTERFLY EFFECTS LLC.
Entity Type:Organization
Organization Name:BUTTERFLY EFFECTS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-633-3634
Mailing Address - Street 1:187 SIERRA VIS
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-7980
Mailing Address - Country:US
Mailing Address - Phone:404-663-3634
Mailing Address - Fax:
Practice Address - Street 1:187 SIERRA VIS
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-7980
Practice Address - Country:US
Practice Address - Phone:404-663-3634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health