| Commonwealth Clinical Group, Inc. | |
|
479 Thomas Jones Way Suite 100 Exton PA 19341-2580 | |
| (484) 879-6751 | |
| (484) 879-6759 |
| Full Name | Commonwealth Clinical Group, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 479 Thomas Jones Way, Exton, Pennsylvania |
| Authorized Official Name and Position | Stacie Basham (BILLING COORDINATOR) |
| Authorized Official Contact | 7173933900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Clinical Group, Inc. 41 E Orange St Lancaster PA 17602-2846 Ph: (717) 393-3900 | Commonwealth Clinical Group, Inc. 479 Thomas Jones Way Suite 100 Exton PA 19341-2580 Ph: (484) 879-6751 |
| NPI Number | 1750706198 |
|---|---|
| Provider Enumeration Date | 02/21/2014 |
| Last Update Date | 09/15/2021 |
| Certification Date | 09/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750706198 | NPI | - | NPPES |
| 102233443 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 326900 (Pennsylvania) | Primary |
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