CHRYSALLIS, INC. (NPI# 1306095617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306095617 |
| Entity Type | Organization |
| Organization Name | CHRYSALLIS, INC. |
| Practice Address |
6495 New Hampshire Ave Suite 303 Hyattsville MD 20783-3245 |
| Practice Telephone | 3018536754 |
| Practice Fax Number | 3018536756 |
| Mailing Telephone | 3018536754 |
| Mailing Fax Number | 3018536756 |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2008-09-10 |
| Authorized Official Name | MS. ILENE TONDELAYO WILSON (PRESIDENT/ CEO) |
| Authorized Official Telephone | 3018536754 |
| Authorized Official Credential | RN BSN |
| 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 | DC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | 039289400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548382401 | Chrysallis, Inc. | Intermediate Care Facility, Mentally Retarded | 3765 1st St Se, Washington, DC 20032-2313 | 2007-04-04 |
| Street Address |
6495 NEW HAMPSHIRE AVE SUITE 303 |
| City | HYATTSVILLE |
| State | MD |
| Zip Code | 20783-3245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700981826 | Melville Cecil Wyse | Dentist | 6495 New Hampshire Ave, Suite 113, Hyattsville, MD 20783-3245 | 2006-09-13 |
| 1679174288 | Marie Tresor Makoutsing Nzongoum | Home Health Aide | 6495 New Hampshire Ave, Hyattsville, MD 20783-3245 | 2020-11-02 |
| 1043819238 | Makaylia Hursey | Home Health Aide | 6495 New Hampshire Ave, Hyattsville, MD 20783-3245 | 2020-10-20 |
| 1265030084 | Specioser Musika | Home Health Aide | 6495 New Hampshire Ave, Hyattsville, MD 20783-3245 | 2020-10-14 |
| 1376141192 | Iyabo Eliphus | Home Health Aide | 6495 New Hampshire Ave, Hyattsville, MD 20783-3245 | 2020-10-14 |
| 1780281113 | Nancy Arriaza | Home Health Aide | 6495 New Hampshire Ave, Hyattsville, MD 20783-3245 | 2020-10-08 |
| 1497352819 | Keara Hammond | Home Health Aide | 6495 New Hampshire Ave, Hyattsville, MD 20783-3245 | 2020-10-08 |
| 1285231605 | Fatmata Sesay | Home Health Aide | 6495 New Hampshire Ave, Hyattsville, MD 20783-3245 | 2020-10-08 |
| 1467059709 | Jahnis Short | Home Health Aide | 6495 New Hampshire Ave, Hyattsville, MD 20783-3245 | 2020-10-08 |
| 1033716477 | Kiara Nieves | Home Health Aide | 6495 New Hampshire Ave, Hyattsville, MD 20783-3245 | 2020-10-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144862954 | Tera Duffer | Physician Assistant | 7506 Adelphi, Hyattsville, MD 20783 | 2019-10-14 |
| 1164999512 | Melorejuvenationsmeloweightloss LLC (dba) Best Pharmacy | Pharmacy | 6495 New Hampshire Av Suite # B130, Hyattsville, MD 20783 | 2018-10-24 |
| 1518446657 | Florentine Madeleine Domche - Pesok | Home Health Aide | 1836 Metzerott Rd Apt 1116, Adelphi, MD 20783 | 2018-08-09 |
| 1306365218 | Alain Samuel Kameni | Home Health Aide | 1906 Dana Dr., Hyattsville, MD 20783 | 2017-09-12 |
| 1871011486 | Justin Lee Blackwell | Counselor | 3501 University Blvd East, Adelphi, MD 20783 | 2017-09-04 |
| 1154843712 | Annmarie Cynthia Wallace | Home Health Aide | 836 Fairoak Ave, Hyattsville, MD 20783 | 2017-07-14 |
| 1063934677 | Dorine Adeline Kouanang Lapa Epse Laakak | Technician | 4043 Greenlawn Drive Apt 100, Hyattsville, MD 20783 | 2017-07-14 |
| 1861914798 | Danielle Marie Graham | Social Worker | 1800 Metzerott Rd, Apt 206, Adelphi, MD 20783 | 2017-07-12 |
| 1336684703 | Evelin Reyes | Home Health Aide | 2121 Ruatan St, Hyattsville, MD 20783 | 2016-12-21 |
| 1689121238 | Carole Nkwignia Nketcha | Home Health Aide | 1908 Erie St Apt 102, Hyattsville, MD 20783 | 2016-09-01 |
| Find all providers in zip 20783 | ||||
| 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 |
|---|---|---|---|---|
| 1518422104 | The Help Foundation International | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 506 Jurgensen Pl, Hyattsville, MD 20785-4870 | 2019-02-07 |
| 1770734014 | Ici Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3450 Toledo Ter, # 209, Hyattsville, MD 20782-1397 | 2008-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427659978 | Your Choices Support Services Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8480 Baltimore National Pike # 141, Ellicott City, MD 21043-3369 | 2020-11-02 |
| 1225638786 | Alternative Dda Home Care Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Reisterstown Rd Ste 180, Baltimore, MD 21208-1313 | 2020-10-26 |
| 1487251195 | Shore Community Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8221 Teal Dr Ste 422, Easton, MD 21601-7212 | 2020-10-06 |
| 1750909875 | Richcroft Incorporated | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11350 Mccormick Rd Ste 700, Hunt Valley, MD 21031-1002 | 2020-07-07 |
| 1710501648 | Together We Stand Support Services Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3702 Evergreen Ave, Baltimore, MD 21206-3420 | 2020-06-06 |
| 1447870985 | Palmer's Care Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3410 Gateshead Manor Way Apt 201, Silver Spring, MD 20904-6114 | 2020-04-24 |
| 1477185338 | A.w. Holdings of Maryland, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 808 Klees Mill Rd, Westminster, MD 21157-8230 | 2020-02-10 |
| 1851930382 | Daylight Healthcare Services, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3812 Pikeswood Dr, Randallstown, MD 21133-2710 | 2020-01-01 |
| 1205479763 | Oasis Plus Social Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4446 Regalwood Ter, Burtonsville, MD 20866-2227 | 2019-10-28 |
| 1003459777 | Walter Obi | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4201 Brookside Oaks, Owings Mills, MD 21117-5168 | 2019-10-24 |
| Find all providers with the same taxonomy | ||||
| City | HYATTSVILLE |
| Zip Code | 20783 |
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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.