# CHRYSALIS UTAH, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CHRYSALIS UTAH, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356843114
- **Legal business name:** CHRYSALIS UTAH, INC.
- **Authorized official:** RICHARD SLACK (CFO)
- **Authorized official phone:** (801) 655-4950

## Contact information

- **Practice address:** 1507 S 180 E, PROVO, UT 84606-5570
- **Practice address phone:** (801) 426-6661
- **Mailing address:** 1443 W 800 N STE 103, OREM, UT 84057-2878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 03/07/2018
- **Last updated:** 03/07/2018