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Chrysalis
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Southgate, Michigan
NPI 1407077613

Chrysalis is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Southgate, MI. Chrysalis practices in Southgate, MI. The NPI Number for Chrysalis is 1407077613 and holds a License No. (Michigan).

The current practice location address for Chrysalis is 12985 Northline Rd Ste 103, Southgate, MI and can be reached out via phone at 734-282-4630 and via fax at 734-282-4684.

Location: 12985 Northline Rd Ste 103, Southgate, MI, 48195-1194
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1407077613
Provider Name
Chrysalis
Credential
Provider Entity Type
Organization
Address
12985 Northline Rd Ste 103, Southgate, MI, 48195-1194
Phone Number
734-282-4630
Fax Number
734-282-4684
Provider Enumeration Date
05/02/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
12985 Northline Rd Ste 103
City
Southgate
State
Michigan
Zip
48195-1194
Phone Number
734-282-4630
Fax Number
734-282-4684
person
Provider Business Mailing Address Details
Address
12985 Northline Rd Ste 103
City
Southgate
State
Michigan
Zip
48195-1194
Phone Number
734-282-4630
Fax Number
734-282-4684
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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