CHRYSALIS CENTER INC (NPI# 1700961646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700961646 |
| Entity Type | Organization |
| Organization Name | CHRYSALIS CENTER INC |
| Practice Address |
3800 W Broward Blvd Ste 100 Fort Lauderdale FL 33312-1018 |
| Practice Telephone | 9545871008 |
| Practice Fax Number | 9545870080 |
| Mailing Telephone | 9545871008 |
| Mailing Fax Number | 9545870080 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2018-09-25 |
| Authorized Official Name | MS. A. VIVIAN DEMILLE (CFO/CORPORATE COMPLIANCE OFFICER) |
| Authorized Official Telephone | 9545871008 |
| Authorized Official Credential | ESQ. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AMERIGROUP | 251967400 | 01 |
| FL | 076055200 | 05 | |
| FL | 076058700 | 05 | |
| FL | 914696200 | 05 | |
| FL | 075982100 | 05 |
| Street Address |
3800 W BROWARD BLVD STE 100 |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33312-1018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031589 | Joyce Lynch | Social Worker | 3800 W Broward Blvd Ste 100, Fort Lauderdale, FL 33312-1018 | 2020-07-31 |
| 1275197295 | Grace A Gardiner | Counselor | 3800 W Broward Blvd Ste 100, Fort Lauderdale, FL 33312-1018 | 2019-04-24 |
| 1558832675 | Lorraine Alison Brewster | Marriage & Family Therapist | 3800 W Broward Blvd Ste 100, Fort Lauderdale, FL 33312-1018 | 2018-12-16 |
| 1447729801 | Bianca Guadalupe Aurich | Counselor | 3800 W Broward Blvd Ste 100, Fort Lauderdale, FL 33312-1018 | 2018-11-15 |
| 1790288082 | Rachelle Cliche | Social Worker | 3800 W Broward Blvd Ste 100, Fort Lauderdale, FL 33312 | 2018-03-13 |
| 1003267840 | Monique Beckford | Counselor | 3800 W Broward Blvd Ste 100, Fort Lauderdale, FL 33312-1018 | 2016-06-22 |
| 1063849461 | Alicia Olivieri | Counselor | 3800 W Broward Blvd Ste 100, Fort Lauderdale, FL 33312-1018 | 2013-09-30 |
| 1497062988 | Kory Brudzinski | Counselor | 3800 W Broward Blvd Ste 100, Fort Lauderdale, FL 33312-1018 | 2010-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679112965 | Krista Moreno | Marriage & Family Therapist | 2699 Stirling Road Building C Suite 403e, Fort Lauderdale, FL 33312 | 2020-01-03 |
| 1700428026 | Caring Village of Lauderdale LLC | Assisted Living Facility | 408-412 Sw 7th Ave, Fort Lauderdale, FL 33312 | 2019-10-09 |
| 1548742356 | Inspire Acupuncture | Acupuncturist | 1000 Riverside Drive, Fort Lauderdale, FL 33312 | 2018-08-29 |
| 1447762919 | Daniel Desta Bekele | General Practice | 1001 W Las Olas Blvd Apt 4, Fort Lauderdale, FL 33312 | 2017-10-24 |
| 1649798653 | Angel Luis Perez | Nurse Practitioner | 3041 Sw 47 Street, Fort Lauderdale, FL 33312 | 2017-08-30 |
| 1902322738 | Ashley Ingrid Rini | Dentist | 1620 Sw 33rd Ave, Fort Lauderdale, FL 33312 | 2017-08-14 |
| 1548794993 | Elise Cruz | Nurse Practitioner | 3301 Sw 16th Street, Fort Lauderdale, FL 33312 | 2017-04-12 |
| 1619415924 | Antoinette Battle | Nurse Practitioner | 3470 Sw 19th Street, Fort Lauderdale, FL 33312 | 2017-02-07 |
| 1902344252 | Melissa Miller | Counselor | 2962 Southwest 26th Terrace, 204, Fort Lauderale, FL 33312 | 2017-02-07 |
| 1164975934 | Brandon Nieves Stella | Technician, Other | 620 Sw 14th Ter, Fort Lauderdale, FL 33312 | 2016-07-28 |
| Find all providers in zip 33312 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669080461 | Northeast Family Services of Florida, Inc. | Community/Behavioral Health | 1122 Ne 18th Ct, Fort Lauderdale, FL 33305-3862 | 2020-07-17 |
| 1689184186 | Innovative Psych Solutions, Inc | Community/Behavioral Health | 110 Se 6th St Ste 1900, Fort Lauderdale, FL 33301-5005 | 2017-10-10 |
| 1245697606 | Childnet, Inc. | Community/Behavioral Health | 1100 W Mcnab Rd, Fort Lauderdale, FL 33309-1116 | 2016-01-15 |
| 1336504786 | South Florida Wellness Network, Inc | Community/Behavioral Health | 2901 W Cypress Creek Rd Ste 105, Fort Lauderdale, FL 33309-1730 | 2015-12-29 |
| 1770921967 | Carmen L. Galano, Psyd, LLC | Community/Behavioral Health | 1130 Sw 30th St, Fort Lauderdale, FL 33315-2924 | 2013-06-10 |
| 1205174877 | Life At Seven Springs | Community/Behavioral Health | 4367 N Federal Hwy, Suite 201, Fort Lauderdale, FL 33308-5213 | 2013-01-16 |
| 1821333717 | Broward Behavioral Health Coalition, Inc. | Community/Behavioral Health | 1715 Se 4th Ave, Fort Lauderdale, FL 33316-2515 | 2012-12-03 |
| 1245588441 | Blue Moon Senior Counseling, LLC. | Community/Behavioral Health | 900 Ne 18th Ave Apt 1207, Fort Lauderdale, FL 33304-3054 | 2012-08-17 |
| 1245595024 | Ami Kids Greater Fort Lauderdale | Community/Behavioral Health | 3220 Sw 4th Ave, Fort Lauderdale, FL 33315-3019 | 2012-07-09 |
| 1033391727 | Broward House, Inc. | Community/Behavioral Health | 501 Se 18th Ct, Fort Lauderdale, FL 33316-2833 | 2007-12-04 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33312 |
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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.