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 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 2 | 251B00000X | Case Management | | | | No |
| 3 | 310400000X | Assisted Living Facility | | | | No |
| 4 | 3104A0625X | Assisted Living Facility | Assisted Living, Mental Illness | | | No |
| 5 | 3104A0630X | Assisted Living Facility | Assisted Living, Behavioral Disturbances | | | No |
| 6 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 7 | 320700000X | Residential Treatment Facility, Physical Disabilities | | | | No |
| 8 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 9 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 10 | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | | | | No |
| 11 | 332B00000X | Durable Medical Equipment & Medical Supplies | | | | No |
| 12 | 374U00000X | Home Health Aide | | | | No |
| 13 | 253J00000X | Foster Care Agency | | | | Yes |
