Provider Demographics
NPI:1710696042
Name:BUTLER'S PRIVATE HOMECARE
Entity Type:Organization
Organization Name:BUTLER'S PRIVATE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-410-7596
Mailing Address - Street 1:746 AVRETT CIR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6676
Mailing Address - Country:US
Mailing Address - Phone:706-951-9535
Mailing Address - Fax:
Practice Address - Street 1:746 AVRETT CIR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-6676
Practice Address - Country:US
Practice Address - Phone:706-951-9535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health