NPIMap

Organization Active NPI

Chrysalis Utah, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Orem, UT
National Provider Identifier
1184033656
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
AO1532 Issued in UT
Legal business name
CHRYSALIS UTAH, LLC
Practice address
1443 W 800 N
Orem, UT 84057-2875
Phone
(801) 404-6023
NPI assigned
Aug 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Authorized official

Name
Jesse Yarger, BCBA
Title
Behavior Analyst
Phone
(801) 404-6023

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X AO1532 UT Primary

Addresses

Primary practice location

1443 W 800 N
Orem, UT 84057-2875

Mailing address

1443 W 800 N
Orem, UT 84057-2875
Phone (801) 404-6023

National Provider Directory

National Provider Directory
Tax ID family
Chrysalis Utah LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1443 W 800 N
Orem, UT 84057
Phone (801) 235-0953

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590624000000",
    "number": "1184033656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 W 800 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572875",
            "telephone_number": "801-404-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 W 800 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572875",
            "telephone_number": "801-404-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS UTAH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-08",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "YARGER",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "801-404-6023",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "UT",
            "license": "AO1532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; 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.