CHRYSALIS TEXAS (NPI# 1073811196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073811196 |
| Entity Type | Organization |
| Organization Name | CHRYSALIS TEXAS |
| Practice Address |
531 E 770 N Orem UT 84097-4102 |
| Practice Telephone | 8016554950 |
| Practice Fax Number | 8016554954 |
| Mailing Telephone | 8016554950 |
| Mailing Fax Number | 8016554954 |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2011-03-14 |
| Authorized Official Name | MARC R CHRISTENSEN (PRESIDENT) |
| Authorized Official Telephone | 8013604672 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHRYSALIS UTAH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | TX | Residential Treatment Facilities |
| Street Address |
531 E 770 N |
| City | OREM |
| State | UT |
| Zip Code | 84097-4102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194273615 | Choice Recovery | Case Management | 531 E 770 N, #b, Orem, UT 84097-4102 | 2016-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700392735 | Scott Harris | Chiropractor | 1425 S State St, Orem, UT 84097 | 2017-12-28 |
| 1457870990 | Summit Laboratory Services | Pathology | 1480 East 820 North, Orem, UT 84097 | 2017-09-15 |
| 1144759275 | White Smiles Family Dentistry | Clinic/Center | 594 E 800 S Suite G, Orem, UT 84097 | 2017-06-12 |
| 1801322367 | Mallory Hendrickson | Assistant Behavior Analyst | 744 E 1650 S, Orem, UT 84097 | 2017-05-03 |
| 1841648664 | National Vision, Inc. | Technician/Technologist | 545 E University Pkwy, Ste 103, Orem, UT 84097 | 2016-06-02 |
| 1538435045 | Wasatch Mental Health | Case Management | 1127 N 1450 E, Orem, UT 84097 | 2012-03-29 |
| 1366720104 | Deseret Counseling Inc | Social Worker | 1325 South 800 East, Suite 115 Room 115 B, Orem, UT 84097 | 2011-07-27 |
| 1598056053 | Uhs of Provo Canyon Inc | Psychiatric Residential Treatment Facility | 1350 E 750 North, Orem, UT 84097 | 2011-05-02 |
| 1659677219 | Francisco Xavier Ampuero | Counselor | 1015 So. State Street, Bsmt. Office, Orem, UT 84097 | 2011-01-31 |
| 1275835449 | Pursonna Tuiletufuga | Counselor | 1160 South Main Street, Suite 180a, Orem, UT 84097 | 2010-11-22 |
| Find all providers in zip 84097 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164542379 | Key Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1361 S 740 E, Orem, UT 84097-8083 | 2007-03-30 |
| 1285738476 | Chrysalis Nevada, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 223 W 520 N, Orem, UT 84057-4696 | 2006-09-11 |
| 1184033656 | Chrysalis Utah, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1443 W 800 N, Orem, UT 84057-2875 | 2014-08-08 |
| 1316044852 | Chrysalis Enterprises, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 223 W 520 N, Orem, UT 84057-4696 | 2006-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942748249 | Black Shirt Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 513 S 3040 W, Lehi, UT 84043-5636 | 2017-02-07 |
| 1881002061 | Compass Academy Transitional Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4800 E 17160 N, Moroni, UT 84646 | 2014-07-31 |
| 1780914572 | Kt&t, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1140 36th St Ste 285, Ogden, UT 84403-2064 | 2009-12-30 |
| 1386897650 | Friends for Life, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2228 S 2325 W, Syracuse, UT 84075-9282 | 2008-10-29 |
| 1164673331 | Empowered for Life, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5004 West Janette Drive, West Valley City, UT 84120 | 2008-10-07 |
| 1932359833 | Tri Connections, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1921 N 1120 W, Provo, UT 84604-1044 | 2008-09-26 |
| 1093920613 | Brighter Futures, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6138 S 380 W, Salt Lake City, UT 84107-6988 | 2007-05-14 |
| 1013059948 | Choices Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 484 South 1st East, Wellington, UT 84542-0155 | 2007-02-14 |
| 1730234733 | Eaton Alliance, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9710 S 700 E, 111, Sandy, UT 84070-3594 | 2007-01-23 |
| 1528110681 | Bjb, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3511 W 7340 S, West Jordan, UT 84084-2770 | 2007-01-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.