Chrysalis Center Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CHRYSALIS CENTER INC

Practice address

3521 W Broward Blvd
Lauderhill, FL 33312-1048

Phone

(954) 587-1008

NPI assigned

Aug 12, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jo-Ann Prisco, LMHC

Title

VP Contracts and Payor Relations

Phone

(772) 214-1010

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Chrysalis Health Doing business as

Electronic endpoints 1

Tax ID family

Chrysalis Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Chrysalis Center, LLC

  • Community/Behavioral Health Agency
  • Panama City, FL
  • NPI 1598549461
  NPD tax ID
• Chrysalis Center, LLC

  • Community/Behavioral Health Agency
  • Fort Lauderdale, FL
  • NPI 1700961646
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paulette Gopman Perlowin, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hollywood, FL
  • NPI 1639230899
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1174838262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 W BROWARD BLVD STE 100",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121018",
            "telephone_number": "954-587-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 W BROWARD BLVD",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333121048",
            "telephone_number": "954-587-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "PRISCO",
        "authorized_official_first_name": "JO-ANN",
        "authorized_official_title_or_position": "VP CONTRACTS AND PAYOR RELATIONS",
        "authorized_official_telephone_number": "772-214-1010",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MH 7951",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075982100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@chrysalishealth.com",
            "affiliation": "N",
            "address_1": "3521 W Broward Blvd",
            "city": "Ft Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333121048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Chrysalis Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Lauderhill, FL
• Providers in Lauderhill, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.