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NPI Code Detail

MEDICARE: PROJECT CHESAPEAKE, LLC

MEDICARE: PROJECT CHESAPEAKE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1366944142
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROJECT CHESAPEAKE, LLC
Provider Business Mailing Address
First Line : 185 ADMIRAL COCHRANE DR STE 120
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-7600
Country : US
Telephone Number : 443-440-5780
Fax Number :
Provider Business Practice Location Address
First Line : 69 SHERRY LN
Second Line :
City : PRINCE FREDERICK
State : MD
Zip : 20678-3231
Country : US
Telephone Number : 443-968-8331
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : JOSEPH ROGERS
Credential :
Telephone Number : 443-440-5780
Provider Enumeration Date : 03/07/2018
Last Update Date : 05/01/2019

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Directions to “PROJECT CHESAPEAKE, LLC ” Practice Location

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