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 | | MHL 092-504 | NORTH CAROLINA | No |
| 2 | 251S00000X | Community/Behavioral Health | | | | 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 | 3408753 | MEDICAID | NORTH CAROLINA | |
| 2 | H0045 B3 IND. | OTHER | NORTH CAROLINA | IPRS STATE RESPITE |
| 3 | H0045HQ RESPITE G CH | MEDICAID | NORTH CAROLINA | |
| 4 | T2021 DAY SUPPT. ADU | MEDICAID | NORTH CAROLINA | |
| 5 | YP010 RESPITE | OTHER | NORTH CAROLINA | NCSTATE IPRS |
| 6 | H0045HB RESPITE ADUL | MEDICAID | NORTH CAROLINA | |
| 7 | T2025 SPEC. CONSULT | MEDICAID | NORTH CAROLINA | |
| 8 | S5150 INN. RESPITE | MEDICAID | NORTH CAROLINA | |
| 9 | B3H0045HBHQ RESPITE | MEDICAID | NORTH CAROLINA | |