Organization
PROSPECT CCMC, LLC
Active
Other names
Community/Behavioral Health
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) 619-8600
Mailing address
301 W 15TH ST, CHESTER, PA 19013-5300
(610) 619-8600
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/17/2016
Last updated
01/15/2021
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