MEDICARE: CHRYSALIS RECOVERY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770714024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRYSALIS RECOVERY CENTER LLC

Provider Business Mailing Address
First Line	:	112 S STATE ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301
Country	:	US
Telephone Number	:	603-998-4210
Fax Number	:	603-532-0720

Provider Business Practice Location Address
First Line	:	112 S STATE ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-3528
Country	:	US
Telephone Number	:	603-998-4210
Fax Number	:	603-532-0720

Authorized Official
Title or Position	:	CEO
Name	:	KIRSTEN MACARTHUR
Credential	:	MS, LADC, LADC-1, SA
Telephone Number	:	603-998-4210

Provider Enumeration Date	:	08/05/2009
Last Update Date	:	09/02/2025

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