| NPI | 1295866911 |
|---|---|
| Former Legal Business Name | CHRYSALIS |
| Entity Type | Organization |
| Authorized Contact | BEVERLY DUSSO Executive Director 612-767-6690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: MN 800487-2-MCH) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MN 800488-3-CDT) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-11-12 |