Healthcare Provider Details

I. General information

NPI: 1477984300
Provider Name (Legal Business Name): ACADIA ACQUISITION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 OLDE HOMESTEAD LN STE 201
LANCASTER PA
17601-6751
US

IV. Provider business mailing address

1817 OLDE HOMESTEAD LN STE 201
LANCASTER PA
17601-6751
US

V. Phone/Fax

Practice location:
  • Phone: 717-394-3466
  • Fax: 717-394-1252
Mailing address:
  • Phone: 717-394-3466
  • Fax: 717-394-1252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: JACK W POPLAR
Title or Position: PRESIDENT/CEO
Credential: MRA, CRC, LPC
Phone: 717-394-3466