CHRYSALIS (NPI# 1770921868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770921868 |
| Entity Type | Organization |
| Organization Name | CHRYSALIS |
| Other Organization Name | INNERCHANGE CHRYSALIS |
| Practice Address |
77 Trails End Rd Eureka MT 59917-9332 |
| Mailing Address |
86 N University Ave Ste 450 Provo UT 84601-5734 |
| Practice Telephone | 4068895577 |
| Mailing Telephone | 4352295498 |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2016-05-24 |
| Authorized Official Name | HEATHER BLACK (INSURANCE SPECIALIST) |
| Authorized Official Telephone | 4352295498 |
| Is Organization Subpart | Y |
| Parent Organization Name | INNERCHANGE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Innerchange Chrysalis | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407077613 | Chrysalis | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 12985 Northline Rd Ste 103, Southgate, MI 48195-1194 | 2007-05-02 |
| 1346573417 | Chrysalis | Counselor | 1312 Hamilton Pl, Suite 105, High Point, NC 27265 | 2009-09-08 |
| 1134304926 | Chrysalis | Community Health Worker | 57 Trails End Rd, Eureka, MT 59917-9332 | 2007-12-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Chrysalis | 2020 E. Bijoiu, Number 3, Colorado Springs, CO 80909 |
| New York State Corporations | CHRYSALIS ACUPUNCTURE, PLLC | 928 Broadway, Ste 801, New York, Ny 10010 |
| Oregon Corporations, Companies and Business Names | CHRYSALIS ADVENTURES, LLC | 3250 Ne Mlk Jr Blvd #111, Portland, OR 97212 |
| Oregon Corporations, Companies and Business Names | CHRYSALIS ADVISORY GROUP | 480 Ne Bellevue Dr, Suite 114, Bend, OR 97701 |
| Oregon Corporations, Companies and Business Names | CHRYSALIS AERIAL ACADEMY | 345 Ne 8th St, Gresham, OR 97030 |
| Colorado Business Entities | Chrysalis Alchemy, llc | 18323 E Union Dr, Aurora, CO 80015 |
| Colorado Business Entities | Chrysalis Angel Fund LLC | 1900 Wazee Street, Suite 300, Denver, CO 80202 |
| Colorado Business Entities | Chrysalis Archaeological & Environmental Consulting, LLC | 1002 Montrose Ave, Colorado Springs, CO 80905 |
| System for Award Management (SAM) Entities | CHRYSALIS ARCHAEOLOGY | 4110 Quentin Rd, Brooklyn, NY 11234-4322 |
| System for Award Management (SAM) Entities | CHRYSALIS ART CONSERVATION, INC. | 799 Main St. Ste L, Half Moon Bay, CA 94019-1946 |
| Street Address |
77 TRAILS END RD |
| City | EUREKA |
| State | MT |
| Zip Code | 59917-9332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346534393 | Jacob Sparks | Marriage & Family Therapist | 77 Trails End Rd, Eureka, MT 59917 | 2011-06-07 |
| 1902446867 | Kendra Meiklejohn | Social Worker | 77 Trails End Rd, Eureka, MT 59917-9332 | 2020-01-08 |
| 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 |
| 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 |
| 1427259407 | Richard Dee Brewer | Pharmacist | 998 Hwy 93n, Eureka, MT 59917 | 2007-05-29 |
| Find all providers in zip 59917 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760017701 | Prosper Adolescent Care LLC | Psychiatric Residential Treatment Facility | 31733 S Fork Yaak Rd Ste B, Troy, MT 59935-8681 | 2020-03-10 |
| 1821444340 | Phoenix Mountain Collaborative Dba Explorations | Psychiatric Residential Treatment Facility | 119 S Hill Rd, Trout Creek, MT 59874-9634 | 2016-05-13 |
| 1578769980 | Clearview Horizon Inc | Psychiatric Residential Treatment Facility | 20 Bear Foot Ln, Heron, MT 59844-9522 | 2007-06-22 |
| 1306981238 | Kids Behavioral Health of Montana Inc | Psychiatric Residential Treatment Facility | 55 Basin Creek Rd, Butte, MT 59701-9704 | 2007-02-20 |
| 1912456856 | Reflections Academy, Inc. | Psychiatric Residential Treatment Facility | 171 Harlow Rd, Thompson Falls, MT 59873 | 2016-10-03 |
| 1255704508 | Montana Children's Home and Hospital | Psychiatric Residential Treatment Facility | 2755 Colonial Dr, Helena, MT 59601-4926 | 2015-11-09 |
| 1952740508 | Acadia Healthcare | Psychiatric Residential Treatment Facility | 55 Basin Creek Rd, Butte, MT 59701-9704 | 2013-06-17 |
| 1184806432 | Montana Academy, Incorporated | Psychiatric Residential Treatment Facility | 9705 Lost Prairie Rd, Marion, MT 59925-9844 | 2007-11-28 |
| 1386836286 | Kids Behavioral Health of Montana | Psychiatric Residential Treatment Facility | 55 Basin Creek Rd, Butte, MT 59701-9704 | 2007-08-14 |
| 1558553453 | Kids Behavioral Health of Montana | Psychiatric Residential Treatment Facility | 55 Basin Creek Rd, Butte, MT 59701-9704 | 2007-08-14 |
| 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.