Provider Demographics
NPI:1306167127
Name:BUTLER'S COMMUNITY SERVICES, INC.
Entity type:Organization
Organization Name:BUTLER'S COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:IDWELLA
Authorized Official - Middle Name:GAINES
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-592-3200
Mailing Address - Street 1:3771 HIGHWAY 69
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32443-2149
Mailing Address - Country:US
Mailing Address - Phone:850-592-3200
Mailing Address - Fax:850-592-8669
Practice Address - Street 1:3771 HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:FL
Practice Address - Zip Code:32443-2149
Practice Address - Country:US
Practice Address - Phone:850-592-3200
Practice Address - Fax:850-592-8669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL450644896Medicaid
FL450644898Medicaid