NPIMap

Organization Active NPI

Chrysalis House Inc

  • Substance Abuse Rehabilitation Facility
  • Crownsville, MD
National Provider Identifier
1942281423
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
14717 Issued in MD
Legal business name
CHRYSALIS HOUSE INC
Practice address
1570 Crownsville Rd
Crownsville, MD 21032-2306
Phone
(410) 974-6829
Fax
(410) 974-6350
NPI assigned
Nov 10, 2005
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
Lorene Lake
Title
Executive Director
Phone
(410) 974-6829

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 14717 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

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": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942281423",
    "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",
            "fax_number": "410-974-6350"
        },
        {
            "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",
            "fax_number": "410-974-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "LORENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-974-6829"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MD",
            "license": "14717",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 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.