Provider Demographics
NPI:1700858040
Name:CHESAPEAKE CENTER INC
Entity Type:Organization
Organization Name:CHESAPEAKE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:703-924-4148
Mailing Address - Street 1:6506 LOISDALE RD
Mailing Address - Street 2:STE 300
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-1824
Mailing Address - Country:US
Mailing Address - Phone:703-924-4100
Mailing Address - Fax:703-922-0638
Practice Address - Street 1:6506 LOISDALE RD
Practice Address - Street 2:STE 300
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1824
Practice Address - Country:US
Practice Address - Phone:703-924-4100
Practice Address - Fax:703-922-0638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
291751OtherAMERICGRP
291751OtherAMERICGRP