Provider Demographics
NPI:1922120849
Name:CHEAPEAKE BEHAVIORAL HEALTH PA
Entity Type:Organization
Organization Name:CHEAPEAKE BEHAVIORAL HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-398-4222
Mailing Address - Street 1:215 NORTH ST # D
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5505
Mailing Address - Country:US
Mailing Address - Phone:410-398-4222
Mailing Address - Fax:410-398-8678
Practice Address - Street 1:215 NORTH ST # D
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5505
Practice Address - Country:US
Practice Address - Phone:410-398-4222
Practice Address - Fax:410-398-8678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01670251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health