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 | 251K00000X | Public Health or Welfare | | | | No |
| 2 | 251S00000X | Community/Behavioral Health | | | | No |
| 3 | 251T00000X | Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | | | | No |
| 4 | 261QA0005X | Clinic/Center | Ambulatory Family Planning Facility | | | No |
| 5 | 261QC1500X | Clinic/Center | Community Health | | | No |
| 6 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 7 | 261QP0905X | Clinic/Center | Public Health, State or Local | | | No |
| 8 | 302R00000X | Health Maintenance Organization | | | | No |
| 9 | 261QP0904X | Clinic/Center | Public Health, Federal | | | Yes |