Provider Demographics
NPI:1154823920
Name:PROJECT CHESAPEAKE, LLC
Entity Type:Organization
Organization Name:PROJECT CHESAPEAKE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-440-5780
Mailing Address - Street 1:185 ADMIRAL COCHRANE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7600
Mailing Address - Country:US
Mailing Address - Phone:443-440-5780
Mailing Address - Fax:
Practice Address - Street 1:114 MARKET ST STE 103
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-1066
Practice Address - Country:US
Practice Address - Phone:443-262-0425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health