Provider Demographics
NPI:1831317296
Name:CAPITAL AREA INTERMEDIATE UNIT
Entity Type:Organization
Organization Name:CAPITAL AREA INTERMEDIATE UNIT
Other - Org Name:CAPITAL AREA PARTIAL PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MUSKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:717-732-8400
Mailing Address - Street 1:1044 N MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112
Mailing Address - Country:US
Mailing Address - Phone:717-732-8471
Mailing Address - Fax:
Practice Address - Street 1:1044 N MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112
Practice Address - Country:US
Practice Address - Phone:717-732-8471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA320970261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health