NPI | 1003612698 |
---|---|
Former Legal Business Name | BLACK BUTTERFLY GROWTH CENTER, LLC |
Entity Type | Organization |
Authorized Contact | TRANIECE MARIE DUNCAN Owner 502-500-2875 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2025-02-24 |
Last Update Date | 2025-02-24 |