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Organization
COMMONWEALTH CLINICAL GROUP, INC.
Active
Organization
COMMONWEALTH CLINICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACIE BASHAM (BILLING COORDINATOR)
(717) 393-3900
Entity
Organization
Contact information
Practice address
479 THOMAS JONES WAY STE 100, EXTON, PA 19341-2585
(484) 879-6751
(484) 879-6759
Mailing address
41 E ORANGE ST, LANCASTER, PA 17602-2846
(717) 393-3900
(717) 393-7900
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/27/2020
Last updated
09/15/2021
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