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 | 101YM0800X | Counselor | Mental Health | | | No |
| 2 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 3 | 177F00000X | Lodging | | | | No |
| 4 | 251S00000X | Community/Behavioral Health | | | | No |
| 5 | 261QC1500X | Clinic/Center | Community Health | | | No |
| 6 | 174200000X | Meals | | | | No |
| 7 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 8 | 251X00000X | Supports Brokerage | | | | No |
| 9 | 3245S0500X | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | | | No |
| 10 | 347C00000X | Private Vehicle | | | | No |
| 11 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 12 | 251C00000X | Day Training, Developmentally Disabled Services | | | | No |
| 13 | 253Z00000X | In Home Supportive Care | | | | Yes |