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 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
| 2 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 3 | 253Z00000X | In Home Supportive Care | | | | No |
| 4 | 251E00000X | Home Health | | | | No |
| 5 | 251S00000X | Community/Behavioral Health | | | | No |
| 6 | 261QA0600X | Clinic/Center | Adult Day Care | | | No |
| 7 | 261QD1600X | Clinic/Center | Developmental Disabilities | | | No |
| 8 | 3104A0625X | Assisted Living Facility | Assisted Living, Mental Illness | | | No |
| 9 | 3104A0630X | Assisted Living Facility | Assisted Living, Behavioral Disturbances | | | No |
| 10 | 310500000X | Intermediate Care Facility, Mental Illness | | | | No |
| 11 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
| 12 | 320700000X | Residential Treatment Facility, Physical Disabilities | | | | No |
| 13 | 323P00000X | Psychiatric Residential Treatment Facility | | | | No |
| 14 | 347C00000X | Private Vehicle | | | | No |
| 15 | 261QM0850X | Clinic/Center | Adult Mental Health | | | Yes |
