NPIMap

Organization Active NPI

Chrysalis House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Crownsville, MD
National Provider Identifier
1316477573
Registry record updated Jun 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
0020092269 Issued in MD
Legal business name
CHRYSALIS HOUSE, INC.
Practice address
1570 Crownsville Rd
Crownsville, MD 21032-2306
Phone
(410) 974-6829
NPI assigned
Jun 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2017

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

Authorized official

Name
Mr. Christopher J. McCabe, MBA
Title
Executive Director
Phone
(410) 974-6829

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 0020092269 MD Primary

Addresses

Primary practice location

1570 Crownsville Rd
Crownsville, MD 21032-2306

Mailing address

1570 Crownsville Rd
Crownsville, MD 21032-2306
Phone (410) 974-6829

Other identifiers 1

IdentifierTypeStateIssuer
1386094803MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Avery Halfway House5 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.

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497830400000",
    "number": "1316477573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 CROWNSVILLE RD",
            "city": "CROWNSVILLE",
            "state": "MD",
            "postal_code": "210322306",
            "telephone_number": "410-974-6829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 CROWNSVILLE RD",
            "city": "CROWNSVILLE",
            "state": "MD",
            "postal_code": "210322306",
            "telephone_number": "410-974-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-19",
        "last_updated": "2017-06-19",
        "status": "A",
        "authorized_official_last_name": "MCCABE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-974-6829",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MD",
            "license": "0020092269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386094803",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crownsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; 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.