| Prospect Ccmc, Llc | |
|
301 W 15th St Chester PA 19013-5300 | |
| (610) 619-8600 | |
| Not Available |
| Full Name | Prospect Ccmc, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 301 W 15th St, Chester, Pennsylvania |
| Authorized Official Name and Position | Robert Jon Elders (SECRETARY) |
| Authorized Official Contact | 7147881249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prospect Ccmc, Llc 301 W 15th St Chester PA 19013-5300 Ph: (610) 619-8600 | Prospect Ccmc, Llc 301 W 15th St Chester PA 19013-5300 Ph: (610) 619-8600 |
| NPI Number | 1437506755 |
|---|---|
| Provider Enumeration Date | 05/17/2016 |
| Last Update Date | 01/15/2021 |
| Certification Date | 01/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437506755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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