Provider Demographics
NPI:1194483578
Name:THE BUTTERFLY BEHAVIORAL CENTER
Entity type:Organization
Organization Name:THE BUTTERFLY BEHAVIORAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MARYROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:CACHOLA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:760-413-8611
Mailing Address - Street 1:31200 LANDAU BLVD APT 2810
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-5146
Mailing Address - Country:US
Mailing Address - Phone:760-413-8611
Mailing Address - Fax:
Practice Address - Street 1:31200 LANDAU BLVD APT 2810
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-5146
Practice Address - Country:US
Practice Address - Phone:760-413-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty