Chrysalize, LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

CHRYSALIZE, LLC

Practice address

215 Highway 965 NE Ste 2
North Liberty, IA 52317-9091

Phone

(319) 888-0057

NPI assigned

Mar 20, 2023

Last updated

Mar 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Flint Miller

Title

Owner

Phone

(319) 888-0057

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1205538675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S FRONT ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179702",
            "telephone_number": "319-888-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HIGHWAY 965 NE STE 2",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179091",
            "telephone_number": "319-888-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIZE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "FLINT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-888-0057"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.