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 | 251C00000X | Day Training, Developmentally Disabled Services | | | | No |
| 2 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 3 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 4 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 5 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | Yes |
| 6 | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | | | | No |
| 7 | 3245S0500X | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | | | No |
| 8 | 385HR2055X | Respite Care | Respite Care, Mental Illness, Child | | | No |
| 9 | 385HR2060X | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities | | | No |
