Provider Demographics
NPI:1629075791
Name:ACADIA, INC.
Entity Type:Organization
Organization Name:ACADIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:BUSSANMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-394-3466
Mailing Address - Street 1:1817 OLDE HOMESTEAD LN
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6751
Mailing Address - Country:US
Mailing Address - Phone:717-394-3466
Mailing Address - Fax:
Practice Address - Street 1:1817 OLDE HOMESTEAD LN
Practice Address - Street 2:SUITE 201
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6751
Practice Address - Country:US
Practice Address - Phone:717-394-3466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001784101YP2500X
PAPS004228L103TC0700X
PAOP005962224Z00000X
PAPT006616L225100000X
PAOC001760L225X00000X
PASL001274L235Z00000X
251B00000X
PA1361060308273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Not Answered251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Not Answered273Y00000XHospital UnitsRehabilitation UnitGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA188748OtherMILLER VALUE OPTIONS
PA50022528OtherMILLER CBC
PA01555234Medicaid
PA01557524Medicaid
PA50022528OtherMILLER CBC
PAR07027Medicare UPIN
PA01557524Medicaid