| Organization Name: | CHESAPEAKE INTEGRATIVE MENTAL HEALTH AND ADDICTIONS TREATMENT, INC. |
| NPI Number: | 1316339377 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREA MICHEALENA LOPEZ (PRESIDENT) |
| Mailing Address: | 46 Wilson Rd Rising Sun |
| State: | MD US |
| Postal Code: | 219112213 |
| Phone Number: | 4434662027 |
| Fax Number: | |
| NPI Enumeration Date: | 02/28/2015 |
| NPI Last Update Date: | 02/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | R183798 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |