Chrysalis

LBN: Chrysalis
Chrysalis is an health care organization with primary practice located at 57 Trails End Rd , Eureka MT 59917-9332. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Community Health Worker, Other Service Providers / Specialist. Other Service Providers / Specialist is the primary health care specialty. Chrysalis can be contacted via phone (406) 889-5577, or through Pannell, Kenny via phone (406) 889-5577.

Contact Information

Primary practice address
57 Trails End Rd Eureka MT 59917-9332
Phone: (406) 889-5577
Fax: (406) 889-5576
Website:
Map and Directions
Authorized official contact:
Name: Pannell, Kenny LCPC
Phone: (406) 889-5577

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X Illinois
Other Service Providers / Specialist 174400000X Illinois

Profile Details

NPI number 1134304926
LBN Legal business name Chrysalis
DBA Doing business as
Authorized official Pannell, Kenny LCPC
Entity Organization
Organization subpart 1 No
Enumeration date Dec 31st, 2007
Last updated Dec 31st, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134304926 NPPES
Montana Other 75473 BLUE CROSS BLUESHIELD

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