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 | 311ZA0620X | Custodial Care Facility | Adult Care Home | | | No |
| 2 | 251E00000X | Home Health | | | | No |
| 3 | 251S00000X | Community/Behavioral Health | | | | No |
| 4 | 253Z00000X | In Home Supportive Care | | | | No |
| 5 | 261QA0600X | Clinic/Center | Adult Day Care | | | No |
| 6 | 261QD1600X | Clinic/Center | Developmental Disabilities | | | No |
| 7 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 8 | 3104A0625X | Assisted Living Facility | Assisted Living, Mental Illness | | | No |
| 9 | 3104A0630X | Assisted Living Facility | Assisted Living, Behavioral Disturbances | | | No |
| 10 | 310500000X | Intermediate Care Facility, Mental Illness | | | | No |
| 11 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 12 | 320700000X | Residential Treatment Facility, Physical Disabilities | | | | No |
| 13 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 14 | 323P00000X | Psychiatric Residential Treatment Facility | | | | No |
| 15 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | Yes |
