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General NPI Number Information
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NPI Number | 1932494366
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Entity Type | Organization
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Legal Business Name | PALS A CHRYSALIS HEALTH COMPANY
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 222 W JOHNSTOWN RD
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City | GAHANNA
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State | OH
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Zip | 43230-2731
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Country | US
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Telephone | 614-532-6420
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Fax |
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Provider Business Mailing Address
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Address Line | 222 W JOHNSTOWN RD
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City | GAHANNA
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State | OH
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Zip | 43230-2731
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Country | US
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Telephone | 614-532-6420
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. AARON MATTHEW BRACONE
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Credential | B.S.
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Telephone | 614-397-9585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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