Provider Demographics
NPI:1790030021
Name:BUTTERFLY EFFECTS
Entity Type:Organization
Organization Name:BUTTERFLY EFFECTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECRUITER
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1888-880-9270
Mailing Address - Street 1:2708 NE 14TH ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-3565
Mailing Address - Country:US
Mailing Address - Phone:188-888-0927
Mailing Address - Fax:
Practice Address - Street 1:640 GREEN VALLEY DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-4628
Practice Address - Country:US
Practice Address - Phone:175-749-5830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management