Provider Demographics
NPI:1922547645
Name:BUTTERFLY BUDDIES
Entity Type:Organization
Organization Name:BUTTERFLY BUDDIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:HANDICAPPED TEACHER
Authorized Official - Phone:732-690-4811
Mailing Address - Street 1:3091 RTE 35
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1519
Mailing Address - Country:US
Mailing Address - Phone:732-690-4811
Mailing Address - Fax:
Practice Address - Street 1:58 WOODSHORE W
Practice Address - Street 2:
Practice Address - City:KEYPORT
Practice Address - State:NJ
Practice Address - Zip Code:07735-6122
Practice Address - Country:US
Practice Address - Phone:732-690-4811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251C00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No252Y00000XAgenciesEarly Intervention Provider Agency