Provider Demographics
NPI:1952739542
Name:CHESAPEAKE MANOR
Entity Type:Organization
Organization Name:CHESAPEAKE MANOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-994-9895
Mailing Address - Street 1:7054 BENT PINE RD
Mailing Address - Street 2:
Mailing Address - City:WILLARDS
Mailing Address - State:MD
Mailing Address - Zip Code:21874-1166
Mailing Address - Country:US
Mailing Address - Phone:410-835-2427
Mailing Address - Fax:
Practice Address - Street 1:7054 BENT PINE RD
Practice Address - Street 2:
Practice Address - City:WILLARDS
Practice Address - State:MD
Practice Address - Zip Code:21874-1166
Practice Address - Country:US
Practice Address - Phone:410-835-2427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility