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 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 2 | 253Z00000X | In Home Supportive Care | | | | No |
| 3 | 251S00000X | Community/Behavioral Health | | | | No |
| 4 | 251J00000X | Nursing Care | | | | No |
| 5 | 3104A0625X | Assisted Living Facility | Assisted Living, Mental Illness | | | No |
| 6 | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | | | | No |
| 7 | 251C00000X | Day Training, Developmentally Disabled Services | | | | No |
| 8 | 3104A0630X | Assisted Living Facility | Assisted Living, Behavioral Disturbances | | | No |
| 9 | 261QA0600X | Clinic/Center | Adult Day Care | | | No |
| 10 | 251G00000X | Hospice Care, Community Based | | | | No |
| 11 | 310400000X | Assisted Living Facility | | | | No |
| 12 | 261QV0200X | Clinic/Center | VA | | | No |
| 13 | 261QD1600X | Clinic/Center | Developmental Disabilities | | | No |
| 14 | 251E00000X | Home Health | | | | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 253J00000X | OTHER | MONTANA | MONTANA |
| 2 | 253Z00000X | OTHER | MONTANA | IN HOME SUPPORTIVE CARE |
| 3 | 34543601 | OTHER | PENNSYLVANIA | PA LICENSE IN-HOME CARE (NON- MEDICAL) |
| 4 | HP0275200 | OTHER | NEW JERSEY | NJ LICENSE HOME HOME CARE LICENCE NUMBER |
| 5 | 171WH0202X | OTHER | MONTANA | MONTANA |
| 6 | 6090501 | OTHER | PENNSYLVANIA | PA LICENSE HOME HEALTH (SKILLED ) |
| 7 | 251E00000X | OTHER | MONTANA | HOME HEALTH |
| 8 | 251E00000X | OTHER | MONTANA | MONTANA |
| 9 | 251J00000X | OTHER | MONTANA | NURSING CARE |
| 10 | 13780995 | OTHER | PENNSYLVANIA | CAQH PROVIDER ID |
| 11 | 251S00000X | OTHER | MONTANA | COMMUNITY/BEHAVIORAL HEALTH/HCBS WAIVER |
| 12 | 103084867-0001 | OTHER | PENNSYLVANIA | PROMISE ID (PPID)# |
| 13 | 171WH0202X | OTHER | MONTANA | CONTRACTOR; HOME MODIFICATIONS |
| 14 | 251E00000X | OTHER | PENNSYLVANIA | PENNSYLVANIA |
| 15 | 251J00000X | OTHER | MONTANA | MONTANA |
| 16 | 253J00000X | OTHER | MONTANA | FOSTER CARE AGENCY |
| 17 | 310400000X | OTHER | MONTANA | ASSISTED LIVING FACILITY |
| 18 | 0890979 | OTHER | NEW JERSEY | NJ MEDICAID ID NUMBER |
| 19 | 251S00000X | OTHER | MONTANA | MONTANA |
