Organization
COMMONWEALTH CLINICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACIE BASHAM (BILLING COORDINATOR)
(717) 393-3900
Entity
Organization
Contact information
Practice address
2444 N 3RD ST, HARRISBURG, PA 17110-1901
(717) 236-3600
(717) 735-1901
Mailing address
41 E ORANGE ST, LANCASTER, PA 17602-2846
(717) 393-3900
(717) 937-9007
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102233443
—
PA
Enumeration date
12/10/2008
Last updated
09/15/2021
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