Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 3104A0625X | Assisted Living Facility | Assisted Living, Mental Illness | | | No |
| 2 | 3104A0630X | Assisted Living Facility | Assisted Living, Behavioral Disturbances | | | No |
| 3 | 311Z00000X | Custodial Care Facility | | | | No |
| 4 | 311ZA0620X | Custodial Care Facility | Adult Care Home | | | No |
| 5 | 315D00000X | Hospice, Inpatient | | | | No |
| 6 | 315P00000X | Intermediate Care Facility, Intellectual Disabilities | | | | No |
| 7 | 320700000X | Residential Treatment Facility, Physical Disabilities | | | | No |
| 8 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 9 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 10 | 310400000X | Assisted Living Facility | | | | Yes |
