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General NPI Number Information
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NPI Number | 1346650173
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE TREATMENT SERVICES LLC
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Dates
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Enumeration Date | 05/01/2014
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 402 MARVEL CT
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City | EASTON
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State | MD
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Zip | 21601-4052
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Country | US
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Telephone | 513-544-1003
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 MONGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45212-2697
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIR OF PAYER RELATIONS/CREDENTIALIN
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Name | AMY MARIE NIEMAN
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Credential |
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Telephone | 513-544-1003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1000645
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 1000645
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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