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 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 2 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 3 | 251S00000X | Community/Behavioral Health | | | | No |
| 4 | 3245S0500X | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | | | No |
| 5 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 6 | 324500000X | Substance Abuse Rehabilitation Facility | | | | No |
| 7 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | Yes |