# CHRYSALIS SCHOOL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811176092
- **Authorized official:** MR. KENNY PANNELL LCPC (CO-OWNER)
- **Authorized official phone:** (406) 889-5575

## Contact information

- **Practice address:** 57 TRAILS END RD, EUREKA, MT 59917-9332
- **Practice address phone:** (406) 889-5577
- **Mailing address:** 57 TRAILS END RD, EUREKA, MT 59917-9332
- **Mailing address phone:** (406) 889-5577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 233169 | IL | Yes |

## Other

- **Enumeration date:** 10/24/2007
- **Last updated:** 10/24/2007