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 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | 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 | 000398901 45G315 | OTHER | TEXAS | ICF-MR WHITE RIVER |
| 2 | 000360701 45G334 | OTHER | TEXAS | ICF-MR LIMERICK LANE |
| 3 | 000360801 45G333 | OTHER | TEXAS | ICF-MR CYPRESS COTTAGE |
| 4 | 000364301 45G362 | OTHER | TEXAS | ICF-MR CUTTEN GREEN |
| 5 | 001000885 45H260 | OTHER | TEXAS | ICF-MR MUELLER HOUSE |
| 6 | 000361201 45G332 | OTHER | TEXAS | ICF-MR HADDINGTON |
| 7 | 000361301 45G336 | OTHER | TEXAS | ICF-MR BARWOOD |
| 8 | 001000897 45H259 | OTHER | TEXAS | ICF-MR SHADY VILLA |
