Organization
PROSPECT CCMC, LLC
Active
Other names
community school #83
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JON ELDERS (SECRETARY)
(714) 788-1249
Entity
Organization
Contact information
Practice address
245 BETHEL RD, CHESTER, PA 19014
(610) 619-8700
Mailing address
245 BETHEL RD, CHESTER, PA 19014
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/12/2016
Last updated
01/15/2021
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