Organization

The Chrysalis Center, Inc

Community/Behavioral Health Agency in Daytona Beach, FL(View on Map)

Legal Business Name

The Chrysalis Center, Inc

NPI Number

1326617762

NPI Type

Organization

Enumeration Date

06/21/2021

Specialties

(Taxonomies)

Code

251S00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

3800 W BROWARD BLVD STE 100
412 S PALMETTO AVE

City

Fort Lauderdale
Daytona Beach

State

FL
FL

Postal Code

33312-1018
32114-4922

Country

US
US

Telephone Number

(954) 587-1008
(954) 587-1008

Authorized Official

Name

Jo-ann Prisco

Title or Position

VP CONTRACTS AND PAYOR RELATIONS

Telephone Number

(772) 214-1010

Identifiers

Identifier

075982121

Identifier State

FL

Identifier Issuer

Unknown

Health Information Exchange

Endpoint Type

DIRECT

Endpoint

credentialing@chrysalishealth.com

Endpoint Description

Unknown

Use

Unknown

Content Type

Unknown

Affiliation

N

Endpoint Location

412 S Palmetto AveDaytona Beach, FL321144922US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/21/2021

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