Provider Demographics
NPI:1568498962
Name:BUCKS COUNTY INTERMEDIATE UNIT 22
Entity Type:Organization
Organization Name:BUCKS COUNTY INTERMEDIATE UNIT 22
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:215-348-2940
Mailing Address - Street 1:705 N SHADY RETREAT RD
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2507
Mailing Address - Country:US
Mailing Address - Phone:215-348-2940
Mailing Address - Fax:215-348-8315
Practice Address - Street 1:705 N SHADY RETREAT RD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2507
Practice Address - Country:US
Practice Address - Phone:215-348-2940
Practice Address - Fax:215-348-8315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014030630001Medicaid