| Commonwealth Clinical Group, Inc. | |
|
450 S 5th St Reading PA 19602-2642 | |
| (610) 372-5645 | |
| (610) 898-9229 |
| Full Name | Commonwealth Clinical Group, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 450 S 5th St, Reading, 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. 450 S 5th St Reading PA 19602-2642 Ph: (610) 372-5645 |
| NPI Number | 1144845231 |
|---|---|
| Provider Enumeration Date | 06/15/2020 |
| Last Update Date | 09/15/2021 |
| Certification Date | 09/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144845231 | NPI | - | NPPES |
| 228900 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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