| The Chrysalis Center, Inc | |
|
412 S Palmetto Ave Daytona Beach FL 32114-4922 | |
| (954) 587-1008 | |
| Not Available |
| Full Name | The Chrysalis Center, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 412 S Palmetto Ave, Daytona Beach, Florida |
| Authorized Official Name and Position | Jo-ann Prisco (VP CONTRACTS AND PAYOR RELATIONS) |
| Authorized Official Contact | 7722141010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Chrysalis Center, Inc 3800 W Broward Blvd Ste 100 Fort Lauderdale FL 33312-1018 Ph: (954) 587-1008 | The Chrysalis Center, Inc 412 S Palmetto Ave Daytona Beach FL 32114-4922 Ph: (954) 587-1008 |
| NPI Number | 1326617762 |
|---|---|
| Provider Enumeration Date | 06/21/2021 |
| Last Update Date | 06/21/2021 |
| Certification Date | 06/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326617762 | NPI | - | NPPES |
| 075982121 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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