Organization
CHRYSALIS, A HOME FOR GIRLS, INC.
Active
Other names
Chrysalis
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD DISMUKES LPC (EXECUTIVE DIRECTOR)
(334) 793-2237
Entity
Organization
Contact information
Practice address
545 JUDGE LOGUE RD, NEWTON, AL 36352-8607
(334) 692-5553
(334) 692-5554
Mailing address
100 WESTSIDE DR, DOTHAN, AL 36303-1908
(334) 793-2237
(334) 712-6256
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
12901
AL
Other
Enumeration date
08/15/2006
Last updated
08/22/2020
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