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Organization

COMMONWEALTH CLINICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STACIE BASHAM (BILLING COORDINATOR)
(177) 393-3900
Entity
Organization

Contact information

Practice address
519 S 29TH ST, HARRISBURG, PA 17104-2106
(717) 393-3900
(717) 393-7900
Mailing address
41 E ORANGE ST, LANCASTER, PA 17602-2846
(717) 393-3900
(717) 393-7900

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
333660
PA
Enumeration date
05/24/2021
Last updated
09/15/2021
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