CHRYSALLIS, INC. (NPI# 1548382401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548382401 |
| Entity Type | Organization |
| Organization Name | CHRYSALLIS, INC. |
| Practice Address |
3765 1st St Se Washington DC 20032-2313 |
| Mailing Address |
6495 New Hampshire Ave Suite 303 Hyattsville MD 20783-3245 |
| Practice Telephone | 2025614393 |
| Practice Fax Number | 3018536756 |
| Mailing Telephone | 3018536754 |
| Mailing Fax Number | 3018536756 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2008-09-10 |
| Authorized Official Name | MS. ILENE T. 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 | 315P00000X | Intermediate Care Facility, Mentally Retarded | HFD03-0229 | DC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | 025901600 | 05 | |
| DC | 026785400 | 05 | |
| DC | 026784600 | 05 | |
| DC | 026786200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306095617 | Chrysallis, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6495 New Hampshire Ave, Suite 303, Hyattsville, MD 20783-3245 | 2008-09-10 |
| Street Address |
3765 1ST ST SE |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20032-2313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336753714 | Ebonie Hawkins | Counselor | 101 Xenia St Suite 200 Sw, Washington, DC 20032 | 2020-09-03 |
| 1639788938 | Richard Quinones | Technician | 4346 Livingston Rd Se, B, Washington, DC 20032 | 2020-07-23 |
| 1720603244 | Ankur Sah Swarnakar | Student in an Organized Health Care Education/Training Program | 1100 Alabama Ave Southeast, 2nd Floor, Suite 238, Washington, DC 20032 | 2020-06-10 |
| 1225659519 | Michael Thomas Moore | Counselor | 920 Belview St. Se, Washington, DC 20032 | 2020-04-28 |
| 1144878240 | Erika Kirkpatrick | Behavior Technician | 1218 Southern Ave Apt304 Se, Washgton Dc, DC 20032 | 2019-08-31 |
| 1982251351 | Agazit Asihel | Counselor | Friendship Charter School 645 Milwaukee Pl, Washington Dc, DC 20032 | 2019-08-21 |
| 1538715412 | Omonike Grace Adeosun | Home Health Aide | 2625 Martin Luther King Jr Ave Se, Apt 1, Washington, DC 20032 | 2019-08-15 |
| 1932753571 | Nadesh Mengwi Muluh | Home Health Aide | 2759 Martin Luther King Jr Avenue, Washington, DC 20032 | 2019-08-01 |
| 1376100115 | Kelsey Hobart | Student in an Organized Health Care Education/Training Program | Dc Dbh Seh Psych Residency 1100 Alabama Avenue, Se, Suite 238, Washington, DC 20032 | 2019-05-28 |
| 1407321417 | Abigail Christine Burke | Physical Therapist | 3146 Arnold Avenue Sw, Washington, DC 20032 | 2018-10-05 |
| Find all providers in zip 20032 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639560980 | Innovative Life Solutions. Inc. | Intermediate Care Facility, Mentally Retarded | 5306 Eastern Ave Ne, Washington, DC 20011-2717 | 2015-02-09 |
| 1992058093 | Innovative Life Solutions, Inc. | Intermediate Care Facility, Mentally Retarded | 2553 36th St Se, Washington, DC 20020-1215 | 2012-10-26 |
| 1356694848 | Innovative Life Solutions, Inc. | Intermediate Care Facility, Mentally Retarded | 3112 Walnut St Ne, Washington, DC 20018-4016 | 2012-10-21 |
| 1518228063 | Innovative Life Solutions, Inc. | Intermediate Care Facility, Mentally Retarded | 5000 E Capitol St Ne, Washington, DC 20019-5326 | 2012-05-31 |
| 1770843526 | Volunteers of America Chesapeake, Inc. | Intermediate Care Facility, Mentally Retarded | 431 53rd St Se, Washington, DC 20019-6171 | 2012-05-25 |
| 1184984064 | Volunteers of America Chesapeake, Inc. | Intermediate Care Facility, Mentally Retarded | 6520 1st St Nw, Washington, DC 20012-2124 | 2012-05-24 |
| 1336409218 | Volunteers of America Chesapeake, Inc. | Intermediate Care Facility, Mentally Retarded | 3020 Stanton Rd Se, Washington, DC 20020-7866 | 2012-05-24 |
| 1801156781 | Volunteers of America Chesapeake, Inc. | Intermediate Care Facility, Mentally Retarded | 1230 Congress St Se, Washington, DC 20032-4543 | 2012-05-24 |
| 1598025694 | Volunteers of America Chesapeake, Inc. | Intermediate Care Facility, Mentally Retarded | 4515 Edson Pl Ne, Washington, DC 20019-4768 | 2012-05-22 |
| 1164735817 | Progressive Habilitative Services, Inc | Intermediate Care Facility, Mentally Retarded | 6405 Chillum Pl Nw, Washington, DC 20012-2133 | 2010-07-23 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20032 |
Please comment or provide details below to improve the information on CHRYSALLIS, INC..
| 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.