Organization
PROSPECT MANCHESTER HOSPITAL, INC.
Active
Other names
inpatient psych unit
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JON ELDERS (SECRETARY)
(714) 788-1249
Entity
Organization
Contact information
Practice address
320 MAIN ST, MANCHESTER, CT 06040-4144
(860) 646-1222
Mailing address
320 MAIN ST, MANCHESTER, CT 06040-4144
(860) 646-1222
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
273R00000X
Psychiatric Hospital Unit
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/13/2016
Last updated
01/11/2021
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