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 | 101Y00000X | Counselor | | | | No |
| 2 | 251C00000X | Day Training, Developmentally Disabled Services | | | | No |
| 3 | 251E00000X | Home Health | | | | No |
| 4 | 251G00000X | Hospice Care, Community Based | | | | No |
| 5 | 251J00000X | Nursing Care | | | | No |
| 6 | 251S00000X | Community/Behavioral Health | | | | No |
| 7 | 251V00000X | Voluntary or Charitable | | | | No |
| 8 | 253Z00000X | In Home Supportive Care | | | | No |
| 9 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 10 | 282J00000X | Religious Nonmedical Health Care Institution | | | | No |
| 11 | 3104A0625X | Assisted Living Facility | Assisted Living, Mental Illness | | | No |
| 12 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 13 | 343800000X | Secured Medical Transport (VAN) | | | | No |
| 14 | 343900000X | Non-emergency Medical Transport (VAN) | | | | No |
| 15 | 251B00000X | Case Management | | | | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 1437564234 | OTHER | NEW JERSEY | N/A |
| 2 | 1437564234 | MEDICAID | NEW JERSEY | |
