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 | 103K00000X | Behavior Analyst | | | | No |
| 2 | 302F00000X | Exclusive Provider Organization | | | | No |
| 3 | 310500000X | Intermediate Care Facility, Mental Illness | | | | No |
| 4 | 311ZA0620X | Custodial Care Facility | Adult Care Home | | | No |
| 5 | 315D00000X | Hospice, Inpatient | | | | No |
| 6 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 7 | 343900000X | Non-emergency Medical Transport (VAN) | | | | No |
| 8 | 347C00000X | Private Vehicle | | | | No |
| 9 | 385HR2060X | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities | | | No |
| 10 | 311Z00000X | Custodial Care Facility | | | | Yes |