NPIMap

Organization Active NPI

Chrysalis, a Home for Girls, Inc.

Doing business as Chrysalis

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Newton, AL
National Provider Identifier
1891808036
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
12901 Issued in AL
Legal business name
CHRYSALIS, A HOME FOR GIRLS, INC.
Doing business as
Chrysalis
Practice address
545 Judge Logue Rd
Newton, AL 36352-8607
Phone
(334) 692-5553
Fax
(334) 692-5554
NPI assigned
Aug 15, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Richard Dismukes, LPC
Title
Executive Director
Phone
(334) 793-2237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 12901 AL Primary

Addresses

Primary practice location

545 Judge Logue Rd
Newton, AL 36352-8607

Mailing address

100 Westside Dr
Dothan, AL 36303-1908
Phone (334) 793-2237

Other names 1

  • Chrysalis Doing business as

National Provider Directory

National Provider Directory

Locations

100 Westside Dr
Dothan, AL 36303
Phone (334) 793-2237

545 Judge Logue Rd
Newton, AL 36352
Phone (334) 692-5553

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891808036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WESTSIDE DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031908",
            "telephone_number": "334-793-2237",
            "fax_number": "334-712-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 JUDGE LOGUE RD",
            "city": "NEWTON",
            "state": "AL",
            "postal_code": "363528607",
            "telephone_number": "334-692-5553",
            "fax_number": "334-692-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS, A HOME FOR GIRLS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DISMUKES",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "334-793-2237",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AL",
            "license": "12901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chrysalis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newton, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.