Provider Demographics
NPI:1639322951
Name:CAPITAL AREA INTERMEDIATE UNIT
Entity Type:Organization
Organization Name:CAPITAL AREA INTERMEDIATE UNIT
Other - Org Name:CAPITAL AREA PARTIAL PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:RIEKER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:717-732-8484
Mailing Address - Street 1:405 E WINDING HILL ROAD
Mailing Address - Street 2:HILL TOP ACADEMY
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055
Mailing Address - Country:US
Mailing Address - Phone:717-732-8484
Mailing Address - Fax:717-732-8432
Practice Address - Street 1:405 E WINDING HILL ROAD
Practice Address - Street 2:HILL TOP ACADEMY
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055
Practice Address - Country:US
Practice Address - Phone:717-732-8484
Practice Address - Fax:717-732-8432
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPITAL AREA INTERMEDIATE UNIT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-30
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA326860261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100006295Medicaid