Commonwealth Clinical Group, Inc. | |
479 Thomas Jones Way Ste 100 Exton PA 19341-2585 | |
(484) 879-6751 | |
(484) 879-6759 |
Full Name | Commonwealth Clinical Group, Inc. |
---|---|
Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 479 Thomas Jones Way Ste 100, 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 Ste 100 Exton PA 19341-2585 Ph: (484) 879-6751 |
NPI Number | 1013530898 |
---|---|
Provider Enumeration Date | 05/27/2020 |
Last Update Date | 09/15/2021 |
Certification Date | 09/15/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013530898 | NPI | - | NPPES |
146330 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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