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Organization

CHRYSALIS SCHOOL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNY PANNELL LCPC (CO-OWNER)
(406) 889-5575
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
10/24/2007
Last updated
10/24/2007
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