CHRYSALIS SCHOOL (NPI# 1811176092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811176092 |
| Entity Type | Organization |
| Organization Name | CHRYSALIS SCHOOL |
| Practice Address |
57 Trails End Rd Eureka MT 59917-9332 |
| Practice Telephone | 4068895577 |
| Mailing Telephone | 4068895577 |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |
| Authorized Official Name | MR. KENNY PANNELL (CO-OWNER) |
| Authorized Official Telephone | 4068895575 |
| Authorized Official Credential | LCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 233169 | IL | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CHRYSALIS SCHOOL INC. | 3880 Se Brooklyn St, Portland, OR 97202 |
| Street Address |
57 TRAILS END RD |
| City | EUREKA |
| State | MT |
| Zip Code | 59917-9332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821142217 | Kenny Zack Pannell | Counselor | 57 Trails End Rd, Eureka, MT 59917-9332 | 2007-01-22 |
| 1134304926 | Chrysalis | Community Health Worker | 57 Trails End Rd, Eureka, MT 59917-9332 | 2007-12-31 |
| 1518089754 | Jane E Fineberg | Social Worker | 57 Trails End Rd, Chrysalis School, Eureka, MT 59917-9332 | 2007-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154892370 | Danielle Bartley | Counselor | 235 7th Street East, Eureka, MT 59917 | 2018-12-16 |
| 1619462801 | Carl William Florey | Massage Therapist | 626 Sherman Creek Road, Eureka, MT 59917 | 2018-06-29 |
| 1609367143 | Chelsea Mae Torres | Massage Therapist | 1711 Hwy 37, Eureka, MT 59917 | 2018-05-21 |
| 1265921639 | Glacier Clinic LLC | Counselor | 99 Mills Spring Rd Ste 1, Eureka, MT 59917 | 2018-05-01 |
| 1568759249 | Lincoln County Community Health Center | Clinic/Center | 100 Dewey Ave, Eureka, MT 59917 | 2011-07-01 |
| 1346534393 | Jacob Sparks | Marriage & Family Therapist | 77 Trails End Rd, Eureka, MT 59917 | 2011-06-07 |
| 1588953632 | Grizzly Eye Center, PC | Optometrist | 317 Dewey Avenue, Eureka, MT 59917 | 2011-03-29 |
| 1881996981 | Home Sweet Home | Assisted Living Facility | 144 Tobacco Valley View Drive, Eureka, MT 59917 | 2010-11-22 |
| 1679889240 | Larry J Lawler | Counselor | 403 1st. Ave. East, Eureka, MT 59917 | 2010-08-20 |
| 1689859654 | Karen Joann Lee | Dental Hygienist | 1210 Highway 93 N, Eureka, MT 59917 | 2008-01-08 |
| Find all providers in zip 59917 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113674 | Big Sky Academy | Residential Treatment Facility, Emotionally Disturbed Children | 12508 Cramer Creek Road, Clinton, MT 59825 | 2020-01-08 |
| 1205055878 | Youth Homes | Residential Treatment Facility, Emotionally Disturbed Children | 550 N California St, Missoula, MT 59802-3913 | 2007-04-24 |
| 1003932104 | Three Rivers Wilderness Programs, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8977 Dry Creek Rd, Belgrade, MT 59714-8121 | 2007-03-21 |
| 1093174500 | B W Caring Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1209 Mossman Dr, Billings, MT 59105-6001 | 2016-02-12 |
| 1467855619 | B W Caring Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1209 Mossman Dr, Billings, MT 59105-6001 | 2014-10-02 |
| 1346495462 | Summit Ranch Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1605 Danielson Rd, Kalispell, MT 59901-7252 | 2008-11-18 |
Please comment or provide details below to improve the information on CHRYSALIS SCHOOL.
| 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.