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 | 106S00000X | Behavior Technician | | | | No |
| 2 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 3 | 175T00000X | Peer Specialist | | | | No |
| 4 | 251C00000X | Day Training, Developmentally Disabled Services | | | | No |
| 5 | 251S00000X | Community/Behavioral Health | | | | No |
| 6 | 261QD1600X | Clinic/Center | Developmental Disabilities | | | No |
| 7 | 261QE0002X | Clinic/Center | Emergency Care | | | No |
| 8 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 9 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 10 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 11 | 3104A0625X | Assisted Living Facility | Assisted Living, Mental Illness | | | No |
| 12 | 3104A0630X | Assisted Living Facility | Assisted Living, Behavioral Disturbances | | | No |
| 13 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 14 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 15 | 251B00000X | Case Management | | | | Yes |