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 | 251B00000X | Case Management | | | | No |
| 2 | 253Z00000X | In Home Supportive Care | | | | No |
| 3 | 261QD1600X | Clinic/Center | Developmental Disabilities | | | No |
| 4 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | Yes |
| 5 | 261QP2300X | Clinic/Center | Primary Care | | | No |
| 6 | 310400000X | Assisted Living Facility | | | | No |
| 7 | 332B00000X | Durable Medical Equipment & Medical Supplies | | | | No |
| 8 | 343900000X | Non-emergency Medical Transport (VAN) | | | | No |
| 9 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |