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 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 2 | 343900000X | Non-emergency Medical Transport (VAN) | | | | No |
| 3 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 4 | 251S00000X | Community/Behavioral Health | | | | No |
| 5 | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | | | | No |
| 6 | 251X00000X | Supports Brokerage | | | | No |
| 7 | 251B00000X | Case Management | | | | No |
| 8 | 251E00000X | Home Health | | | | No |
| 9 | 101YM0800X | Counselor | Mental Health | | | No |
| 10 | 253Z00000X | In Home Supportive Care | | | | No |
| 11 | 251C00000X | Day Training, Developmentally Disabled Services | | | | Yes |