CHRYSALIS UTAH, LLC (NPI# 1184033656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184033656 |
| Entity Type | Organization |
| Organization Name | CHRYSALIS UTAH, LLC |
| Practice Address |
1443 W 800 N Orem UT 84057-2875 |
| Practice Telephone | 8014046023 |
| Mailing Telephone | 8014046023 |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2020-05-28 |
| Authorized Official Name | JESSE YARGER (BEHAVIOR ANALYST) |
| Authorized Official Telephone | 8014046023 |
| Authorized Official Credential | BCBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | AO1532 | UT | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891898045 | Chrysalis Utah, LLC | Counselor | 1443 W 800 N, Suite 103, Orem, UT 84057-2875 | 2006-09-06 |
| Street Address |
1443 W 800 N |
| City | OREM |
| State | UT |
| Zip Code | 84057-2875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891898045 | Chrysalis Utah, LLC | Counselor | 1443 W 800 N, Suite 103, Orem, UT 84057-2875 | 2006-09-06 |
| 1447709191 | Joseph Williams | Dietitian, Registered | 1443 W 800 N, Orem, UT 84057-2875 | 2016-09-22 |
| 1821467598 | Bethany Womack | Behavioral Analyst | 1443 W 800 N, 103, Orem, UT 84057-2875 | 2015-09-23 |
| 1891924585 | Ryan Giles | Social Worker | 1443 W 800 N, Ste 103, Orem, UT 84057-2878 | 2009-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013529932 | Jessica Chang | Social Worker | 870 W, Center, UT 84057 | 2020-08-21 |
| 1750991402 | Dr. Alexander B. Larsen Dds | Dentist | 385 W. Center Street, Orem, UT 84057 | 2020-08-07 |
| 1750911996 | Joanna Ramirez | Behavioral Analyst | 1443 West 800 North #103, Orem, UT 84057 | 2020-01-15 |
| 1790321842 | Nicole Rose Mcdougal | Speech-Language Pathologist | 527 400 N, Ste 2, Orem, UT 84057 | 2019-11-25 |
| 1871151837 | Robert B Fujiki | Speech-Language Pathologist | 1935 N90 W, Orem, UT 84057 | 2019-06-04 |
| 1669965562 | Brian Quigley Inc. | Hearing Instrument Specialist | 895 West Center Street, Orem, UT 84057 | 2018-06-14 |
| 1568960250 | Catherine Collins | Nurse Practitioner | 700 W. 800 N., Suite 220, Orem, UT 84057 | 2018-01-27 |
| 1821596073 | Venice Lucia Wilkes | Physician Assistant | 700 W 800 N # 220, Orem, UT 84057 | 2018-01-23 |
| 1851811160 | Jessie Carlson | Behavior Technician | 475 West 260 North, Orem, UT 84057 | 2017-06-27 |
| 1588013890 | Li Ping Su | Marriage & Family Therapist | 1027 W 1033 N, S108, Orem, UT 84057 | 2016-06-07 |
| Find all providers in zip 84057 | ||||
| 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 |
|---|---|---|---|---|
| 1073811196 | Chrysalis Texas | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 531 E 770 N, Orem, UT 84097-4102 | 2011-03-14 |
| 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 |
| 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.