Provider Demographics
NPI:1932245057
Name:CHESAPEAKE HOME HEALTH CARE INCORPORATED
Entity Type:Organization
Organization Name:CHESAPEAKE HOME HEALTH CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:P
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-249-4333
Mailing Address - Street 1:8300 CORPORATE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2413
Mailing Address - Country:US
Mailing Address - Phone:301-249-4333
Mailing Address - Fax:301-576-3631
Practice Address - Street 1:8300 CORPORATE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-2244
Practice Address - Country:US
Practice Address - Phone:301-249-4333
Practice Address - Fax:301-576-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251E00000X
MDR2469251E00000X, 251J00000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD411231800Medicaid