Organization
LADY BUTTERFLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELICIA A SHANKLIN (EXECUTIVE DIRECTOR)
(678) 902-5239
Entity
Organization
Contact information
Practice address
2755 SAWNEE AVE, SUITE B011, BUFORD, GA 30518-2560
(678) 902-5239
Mailing address
PO BOX 1629, 4160 LOGAN DRIVE, LOGANVILLE, GA 30052
(678) 902-5239
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
251B00000X
Case Management Agency
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
09/21/2016
Last updated
09/29/2017
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