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 | 251T00000X | Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | | | | No |
| 2 | 3104A0625X | Assisted Living Facility | Assisted Living, Mental Illness | | | No |
| 3 | 3104A0630X | Assisted Living Facility | Assisted Living, Behavioral Disturbances | | | No |
| 4 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 5 | 320700000X | Residential Treatment Facility, Physical Disabilities | | | | No |
| 6 | 324500000X | Substance Abuse Rehabilitation Facility | | | | No |
| 7 | 373H00000X | Day Training/Habilitation Specialist | | | | No |
| 8 | 310400000X | Assisted Living Facility | | | | Yes |