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Huntingtown, Maryland

Provider NPI: 1396747358

Organization Information:
Organization Name:  CHESAPEAKE CHURCH
Organization is not Subpart
Authorized Official:  ROBIN  BRUNGARD  MANAGING DIRECTOR  410-2575200

Practice Location:
Tel: 410-257-5200  Fax: 410-257-2442

Business Mailing Address:
Tel: 410-257-5200  Fax: 410-257-2442

Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N101Y00000XBehavioral Health & Social Service Providers
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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