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 | 103TM1800X | Psychologist | Intellectual and Developmental Disabilities | | | No |
| 2 | 163WW0000X | Registered Nurse | Wound Care | | | No |
| 3 | 164X00000X | Licensed Vocational Nurse | | | | No |
| 4 | 225XM0800X | Occupational Therapist | Mental Health | | | No |
| 5 | 251J00000X | Nursing Care | | | | No |
| 6 | 253Z00000X | In Home Supportive Care | | | | No |
| 7 | 320700000X | Residential Treatment Facility, Physical Disabilities | | | | No |
| 8 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 9 | 347C00000X | Private Vehicle | | | | No |
| 10 | 372600000X | Adult Companion | | | | No |
| 11 | 374U00000X | Home Health Aide | | | | No |
| 12 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | Yes |