Organization
COMMONWEALTH CLINICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACIE BASHAM (BILLING COORDINATOR)
(717) 560-7917
Entity
Organization
Contact information
Practice address
450 S 5TH ST, READING, PA 19602-2642
(610) 372-5645
(610) 898-9229
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
326900
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102233443
—
PA
Enumeration date
10/17/2011
Last updated
09/15/2021
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