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General NPI Number Information
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NPI Number | 1578078531
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE TREATMENT SERVICES OCEAN CITY LLC
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 12417 OCEAN GTWY STE 7
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City | OCEAN CITY
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State | MD
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Zip | 21842-9522
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Country | US
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Telephone | 443-373-2113
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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 | 184-438-5676
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Fax |
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Authorized Official
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Title or Position | DIRECTOR PAYER CREDENTIALING
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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 | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number | 102000
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License Number State | MD
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