Healthcare Provider Details

I. General information

NPI: 1407309081
Provider Name (Legal Business Name): CHESAPEAKE TREATMENT SERVICES SALISBURY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2016
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 BELMONT AVE
SALISBURY MD
21804
US

IV. Provider business mailing address

1322 BELMONT AVE
SALISBURY MD
21804
US

V. Phone/Fax

Practice location:
  • Phone: 302-242-4116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number100973
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number100973
License Number StateMD

VIII. Authorized Official

Name: MELISSA BISHOP
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 302-242-4116