Provider Demographics
NPI:1578697629
Name:UPPER CHESAPEAKE HEALTH REHABILITATION SERVICES, LLC
Entity type:Organization
Organization Name:UPPER CHESAPEAKE HEALTH REHABILITATION SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:THOMAS AUGUSTUS
Authorized Official - Last Name:PRIOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-643-3340
Mailing Address - Street 1:515 S TOLLGATE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5234
Mailing Address - Country:US
Mailing Address - Phone:443-643-3980
Mailing Address - Fax:
Practice Address - Street 1:650 MCHENRY RD STE 1100
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2855
Practice Address - Country:US
Practice Address - Phone:443-843-6321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12006273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit