# COMMONWEALTH CLINICAL GROUP, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013530898
- **Authorized official:** STACIE BASHAM (BILLING COORDINATOR)
- **Authorized official phone:** (717) 393-3900

## Contact information

- **Practice address:** 479 THOMAS JONES WAY STE 100, EXTON, PA 19341-2585
- **Practice address phone:** (484) 879-6751
- **Practice address fax:** (484) 879-6759
- **Mailing address:** 41 E ORANGE ST, LANCASTER, PA 17602-2846
- **Mailing address phone:** (717) 393-3900
- **Mailing address fax:** (717) 393-7900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/27/2020
- **Last updated:** 09/15/2021