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Organization

LADY BUTTERFLIES

Active
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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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