Provider Demographics
NPI:1831815406
Name:BLOSSOMING BUTTERFLIES PRENATAL CARE SERVICES LLC
Entity type:Organization
Organization Name:BLOSSOMING BUTTERFLIES PRENATAL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAREIKA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-394-2870
Mailing Address - Street 1:7106 N 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2213
Mailing Address - Country:US
Mailing Address - Phone:414-394-2870
Mailing Address - Fax:
Practice Address - Street 1:7106 N 42ND ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-2213
Practice Address - Country:US
Practice Address - Phone:414-394-2870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management