Chrysalis

LBN: Chrysalis Utah, Llc
Chrysalis is an health care organization with primary practice located at 1443 W 800 N Suite 103, Orem UT 84057-2875. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Behavioral Analyst, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities is the primary health care specialty. Chrysalis Utah, Llc can be contacted via phone (801) 655-4950, or through Christensen, Marc Robert via phone (801) 655-4950.

Contact Information

Primary practice address
1443 W 800 N Suite 103 Orem UT 84057-2875
Phone: (801) 655-4950
Fax: (801) 655-4954
Website:
Map and Directions
Authorized official contact:
Name: Christensen, Marc Robert MMHC
Phone: (801) 655-4950

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X Utah

Profile Details

NPI number 1891898045
LBN Legal business name Chrysalis Utah, Llc
DBA Doing business as Chrysalis
Authorized official Christensen, Marc Robert MMHC
Entity Organization
Organization subpart 1 No
Enumeration date Sep 6th, 2006
Last updated Jul 21st, 2022 - about 2 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 1891898045 NPPES
Utah MEDICAID 788007788140

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