Provider Demographics
NPI:1588435747
Name:BRIGHT BUTTERFLY ACADEMY LLC
Entity type:Organization
Organization Name:BRIGHT BUTTERFLY ACADEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMEIRYS
Authorized Official - Middle Name:
Authorized Official - Last Name:BETANCOURT VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-399-4789
Mailing Address - Street 1:2654 SW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-4756
Mailing Address - Country:US
Mailing Address - Phone:786-399-4789
Mailing Address - Fax:
Practice Address - Street 1:2654 SW 32ND ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-4756
Practice Address - Country:US
Practice Address - Phone:786-399-4789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty