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Organization

PROSPECT CCMC, LLC

Active
Other names
Outpatient Psych
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT JON ELDERS (SECRETARY)
(714) 788-1249
Entity
Organization

Contact information

Practice address
301 W 15TH ST, CHESTER, PA 19013-5300
(610) 619-8700
Mailing address
301 W 15TH ST, CHESTER, PA 19013-5300
(610) 619-8700

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
04/28/2016
Last updated
01/15/2021
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