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 | 174200000X | Meals | | | | No |
| 2 | 177F00000X | Lodging | | | | No |
| 3 | 2084A0401X | Psychiatry & Neurology | Addiction Medicine | | | No |
| 4 | 251B00000X | Case Management | | | | No |
| 5 | 251J00000X | Nursing Care | | | | No |
| 6 | 251S00000X | Community/Behavioral Health | | | | No |
| 7 | 261QC0050X | Clinic/Center | Critical Access Hospital | | | No |
| 8 | 261QE0002X | Clinic/Center | Emergency Care | | | No |
| 9 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 10 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 11 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 12 | 323P00000X | Psychiatric Residential Treatment Facility | | | | No |
| 13 | 324500000X | Substance Abuse Rehabilitation Facility | | | | No |
| 14 | 347B00000X | Bus | | | | No |
| 15 | 283Q00000X | Psychiatric Hospital | | | | 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 | 000000 | OTHER | GEORGIA | DO NOT HAVE |
