NPIMap

Organization Active NPI

Innerchange Chrysalis, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eureka, MT
National Provider Identifier
1417794306
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
INNERCHANGE CHRYSALIS, LLC
Practice address
130 Deanna Tracts Rd
Eureka, MT 59917-9039
Phone
(406) 889-5577
NPI assigned
Jul 9, 2024
Last updated
Apr 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
INNERCHANGE CHRYSALIS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Authorized official

Name
Sharnell Spencer
Title
Credentialing Manager
Phone
(661) 239-6923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

130 Deanna Tracts Rd
Eureka, MT 59917-9039

Mailing address

5500 Ming Ave Ste 410
Bakersfield, CA 93309-4631

Other names 1

  • Chrysalis Other name

National Provider Directory

National Provider Directory
Tax ID family
Chrysalis4 organizations share this tax ID, including this one
Part of
Chrysalis

Other organizations with this tax ID 3

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

Locations

130 Deanna Tracts Rd
Eureka, MT 59917
Phone (406) 889-5577

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1417794306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MING AVE STE 410",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933094631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 DEANNA TRACTS RD",
            "city": "EUREKA",
            "state": "MT",
            "postal_code": "599179039",
            "telephone_number": "406-889-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERCHANGE CHRYSALIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INNERCHANGE CHRYSALIS, LLC",
        "enumeration_date": "2024-07-09",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "SHARNELL",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "661-239-6923"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chrysalis",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Chrysalis",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eureka, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.