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 | 207QA0401X | Family Medicine | Addiction Medicine | | | Yes |
2 | 320700000X | Residential Treatment Facility, Physical Disabilities | | | | No |
3 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | | | | No |
4 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | | No |
5 | 323P00000X | Psychiatric Residential Treatment Facility | | | | No |