NPIMap

Organization Active NPI

Chrysalis House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1518347616
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
CHRYSALIS HOUSE, INC.
Doing business as
Chrysalis House Healthy Start
Practice address
4500 Park Heights Avenue
Baltimore, MD 21215
Phone
(410) 483-8870
Fax
(410) 483-8871
NPI assigned
Jun 3, 2015
Organization subpart
Yes
Parent organization
CHRYSALIS HOUSE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Authorized official

Name
Ms. Debra Lynne Tribble
Title
Program Director
Phone
(410) 483-8870

Specialties & licenses 1

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

Addresses

Primary practice location

4500 Park Heights Avenue
Baltimore, MD 21215

Mailing address

4500 Park Heights Avenue
Baltimore, MD 21215
Phone (410) 483-8870

Other names 1

  • Chrysalis House Healthy Start Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avery Halfway House5 organizations share this tax ID, including this one
Part of
Avery Halfway House

Other organizations with this tax ID 4

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

Locations

4500 Park Heights Ave
Baltimore, MD 21215
Phone (410) 483-8870

Practitioners & affiliated clinicians

Practitioners 1

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": "1433289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1518347616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 PARK HEIGHTS AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "410-483-8870",
            "fax_number": "410-483-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARK HEIGHTS AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "410-483-8870",
            "fax_number": "410-483-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS HOUSE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRYSALIS HOUSE, INC.",
        "enumeration_date": "2015-06-03",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "TRIBBLE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "410-483-8870",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chrysalis House Healthy Start",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.