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 | 171W00000X | Contractor | | | | No |
| 3 | 251C00000X | Day Training, Developmentally Disabled Services | | | | No |
| 4 | 251X00000X | Supports Brokerage | | | | No |
| 5 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 6 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 7 | 332U00000X | Home Delivered Meals | | | | No |
| 8 | 385H00000X | Respite Care | | | | No |
| 9 | 3747P1801X | Technician | Personal Care Attendant | | | No |
| 10 | 261QF0400X | Clinic/Center | Federally Qualified Health Center (FQHC) | | | Yes |