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General NPI Number Information
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NPI Number | 1477063204
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Entity Type | Organization
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Legal Business Name | CHRYSALIS SERVICES, LLC
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 1247 LINCOLN RD STE B
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City | ALLEGAN
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State | MI
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Zip | 49010-9735
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Country | US
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Telephone | 269-512-7200
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Fax | 269-686-8433
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Provider Business Mailing Address
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Address Line | 501 WASHINGTON AVE
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City | HOLLAND
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State | MI
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Zip | 49423-4170
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Country | US
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Telephone | 616-312-8480
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Fax | 269-686-8433
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN DOUGLAS KACMAR
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Credential |
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Telephone | 616-312-8480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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