CHRYSALIS
NPI 1407077613
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Southgate, MI

Q: What is Chrysalis's NPI number?

The NPI number for Chrysalis is 1407077613. It was assigned to this organization in the NPPES registry on May 2, 2007.

Q: What is Chrysalis's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Q: When was this NPI record last updated?

The NPPES record for Chrysalis was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 02, 2007

12985 NORTHLINE RD STE 103, SOUTHGATE, MI 48195(734) 282-4630(734) 282-4684 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Chrysalis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHRYSALIS (NPI 1407077613) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Southgate, Michigan and active in the NPI registry since May 2007. The organization lists Maribeth Alice Knisley, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1407077613

Entity TypeOrganization

Primary Taxonomy320600000X

Legal Business NameCHRYSALIS

Location Address12985 NORTHLINE RD STE 103Southgate, MI 48195-1194

Mailing Address12985 Northline Rd Ste 103Southgate, MI 48195-1194 · (734) 282-4630 · Fax (734) 282-4684

Phone(734) 282-4630

Fax(734) 282-4684

Organization SubpartNo

Authorized OfficialMaribeth Alice KnisleyExecutive Director · (734) 282-4630

Enumeration DateMay 2, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1407077613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320600000X

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.

12985 NORTHLINE RD STE 103, Southgate, MI 48195

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Chrysalis's NPI number?

The NPI number for Chrysalis is 1407077613. It was assigned to this organization in the NPPES registry on May 2, 2007.

Where is Chrysalis located?

Chrysalis is located at 12985 Northline Rd Ste 103, Southgate, MI 48195. The listed phone number is (734) 282-4630.

What is Chrysalis's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Chrysalis was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.