| Organization Name: | PROSPECT CCMC, LLC |
| NPI Number: | 1255785390 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELLEN SHIN (SECRETARY) |
| Mailing Address: | 1 Medical Center Blvd Chester |
| State: | PA US |
| Postal Code: | 190133902 |
| Phone Number: | 6104472000 |
| Fax Number: | 6106197331 |
| NPI Enumeration Date: | 04/14/2016 |
| NPI Last Update Date: | 04/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 273R00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Hospital Units |
| Taxonomy Classification: | Psychiatric Unit |
| Taxonomy Specialization: | |
| Taxonomy Definition: | In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians |