Organization
BUTTERFLY WINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTA NEAL (OWNER)
(702) 544-8742
Entity
Organization
Contact information
Practice address
9445 CORAL BERRY ST, LAS VEGAS, NV 89123-5832
(702) 544-8742
Mailing address
9445 CORAL BERRY ST, LAS VEGAS, NV 89123-5832
(702) 544-8742
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
06/03/2019
Last updated
06/03/2019
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