EVOLUTION OF A BLACK BUTTERFLY LLC NPI 1518637719

NPI Information

NPI: 1518637719
Provider Name: EVOLUTION OF A BLACK BUTTERFLY LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
7335 MEADOWGATE DR
SACRAMENTO, CA
ZIP 95823
Phone: (916) 218-8367
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EVOLUTION OF A BLACK BUTTERFLY LLC is a rehabilitation and substance use disorder clinic center in Sacramento, CA. EVOLUTION OF A BLACK BUTTERFLY LLC NPI is 1518637719. The provider is registered as an organization entity type.

The provider's business location address is:

7335 MEADOWGATE DR
SACRAMENTO, CA
ZIP 95823-473
Phone: (916) 218-8367

The provider's authorized official is Faren Johnson .
The authorized official title is Ceo and has the following contact phone number (916) 218-8367.

The enumeration date for this NPI number is 9/17/2021 and was last updated on 9/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251B00000X	Case Management				No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	R1245580317	OTHER	CALIFORNIA	SUBSTANCE ABUSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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