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General NPI Number Information
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NPI Number | 1215111505
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Entity Type | Organization
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Legal Business Name | CAPITAL AREA INTERMEDIATE UNIT
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 900 LISBURN RD
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City | CAMP HILL
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State | PA
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Zip | 17011-7431
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Country | US
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Telephone | 717-732-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 55 MILLER STREET
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City | SUMMERDALE
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State | PA
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Zip | 17093-0489
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Country | US
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Telephone | 717-732-8400
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | AMY MORTON
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Credential | MS ED ADMINISTRATION
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Telephone | 717-732-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 324850
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License Number State | PA
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