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General NPI Number Information
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NPI Number | 1093828881
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Entity Type | Organization
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Legal Business Name | THE CHRYSALIS FOUNDATION FOR MENTAL HEALTH, INC.-HOPE MEADOW PROGRAM
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 263 PENNY LN
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City | PITTSBORO
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State | NC
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Zip | 27312-4918
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Country | US
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Telephone | 919-968-8680
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Fax | 919-968-9970
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Provider Business Mailing Address
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Address Line | 101 E WEAVER ST STE. G-7
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City | CARRBORO
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State | NC
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Zip | 27510-2370
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Country | US
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Telephone | 919-933-0770
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Fax | 919-933-0767
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JEAN THERESE SUTTER
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Credential | MSW
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Telephone | 919-933-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | MHL-019017
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License Number State | NC
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