Provider Demographics
NPI:1992524466
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:443-440-5788
Mailing Address - Street 1:185 ADMIRAL COCHRANE DR STE 225
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7583
Mailing Address - Country:US
Mailing Address - Phone:443-440-5782
Mailing Address - Fax:
Practice Address - Street 1:13155 GREENSBORO RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:MD
Practice Address - Zip Code:21639-1119
Practice Address - Country:US
Practice Address - Phone:443-440-5790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROJECT CHESAPEAKE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-10
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)