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 | 3104A0625X | Assisted Living Facility | Assisted Living, Mental Illness | | | No |
| 2 | 3104A0630X | Assisted Living Facility | Assisted Living, Behavioral Disturbances | | | No |
| 3 | 311ZA0620X | Custodial Care Facility | Adult Care Home | | | Yes |
| 4 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 5 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 6 | 385H00000X | Respite Care | | | | No |
| 7 | 385HR2055X | Respite Care | Respite Care, Mental Illness, Child | | | No |
| 8 | 385HR2060X | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities | | | No |