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 | | | | No |
| 2 | 251S00000X | Community/Behavioral Health | | | | No |
| 3 | 253Z00000X | In Home Supportive Care | | | | No |
| 4 | 261QA0600X | Clinic/Center | Adult Day Care | | | No |
| 5 | 310400000X | Assisted Living Facility | | | | No |
| 6 | 3104A0625X | Assisted Living Facility | Assisted Living, Mental Illness | | | No |
| 7 | 3104A0630X | Assisted Living Facility | Assisted Living, Behavioral Disturbances | | | No |
| 8 | 311Z00000X | Custodial Care Facility | | | | No |
| 9 | 311ZA0620X | Custodial Care Facility | Adult Care Home | | | No |
| 10 | 315P00000X | Intermediate Care Facility, Intellectual Disabilities | | | | No |
| 11 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 12 | 320700000X | Residential Treatment Facility, Physical Disabilities | | | | No |
| 13 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 14 | 385H00000X | Respite Care | | | | No |
| 15 | 320900000X | Community Based 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 | 000000000 | MEDICAID | UTAH | |
