Healthcare Provider Details

I. General information

NPI: 1912951369
Provider Name (Legal Business Name): COMMONWEALTH CENTER FOR CHILDREN AND ADOLESCENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/25/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 RICHMOND AVE
STAUNTON VA
24401-9146
US

IV. Provider business mailing address

1355 RICHMOND AVE
STAUNTON VA
24401-9146
US

V. Phone/Fax

Practice location:
  • Phone: 540-332-2100
  • Fax: 540-332-2201
Mailing address:
  • Phone: 540-332-2100
  • Fax: 540-332-2203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number297-14-001
License Number StateVA

VIII. Authorized Official

Name: MR. GEORGE NEWSOME
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MHA
Phone: 540-332-2100