LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc NURSING Hospitals FACILITY and Nursing Nursing and Custodial Care 80 (IN-ST) 86 Homes 314000000X Facilities/Skilled Nursing Facility CASE MGMT Case - VENT Other Service Providers Case 81 ASSTD CARE 81 171M00000X Manager/Care Coordinator PERS CARE ATTEND Personal Nursing Service Related (WVR) Care Providers Technician Personal 82 82 Attendant 3747P1801X Care Attendant Community Choices PERS CARE Waiver - ATTEND Caregiver Nursing Service Related (WVR) Temporary Providers Technician Personal 82 8D Support 3747P1801X Care Attendant CTR BASED RESPITE Respite Care Facility Respite 83 CARE (IN-ST) 83 Respite Care 385H00000X Care ADLT DAY HLTH CA Ambulatory Health Care (WVR) Adult Day Facilities Clinic/Center Adult 85 76 Care 261QA0600X Day Care ADLT DAY HLTH CA Ambulatory Health Care (WVR) Facilities Clinic/Center Adult 85 77 Habilitation 261QA0600X Day Care ICF/DD Ambulatory Health Care Facilities/Clinic/Center, 86 NULL 261QR0400X Rehabilitation RURAL HLTH Ambulatory Health Care Rural Health Facilities/Clinic/Center, Rural 87 94 Clinic 261QR1300X Health ICF/DD - GROUP Hospitals Ambulatory Health Care HOME and Nursing Facilities Clinic/Center 88 86 Homes 261QD1600X Developmental Disabilities SPRVISE Supervised INDEP LIV Nursing Service Related 89 (WVR)(IN-ST) 89 Living 372600000X Providers Adult Companion Physician Assistants & Advanced CERTIFIED Practice Nursing NURSE Providers/Midwife, Certified 90 MIDWIFE 16 OB/GYN 367A00000X Nurse CERT REG NURS ANEST Nursing Service Providers 91 (IND & GP) 5 163W00000X Registered Nurse
LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc 80 NURSING FACILITY (IN-ST) 86 Hospitals and Nursing Homes 314000000X Nursing and Custodial Care Facilities/Skilled Nursing Facility 81 CASE MGMT - VENT ASSTD CARE 81 Case 171M00000X Other Service Providers Case Manager/Care Coordinator 82 PERS CARE ATTEND (WVR) 82 Personal Care Attendant 3747P1801X Nursing Service Related Providers Technician Personal Care Attendant 82 PERS CARE ATTEND (WVR) 8D Community Choices Waiver - Caregiver Temporary Support 3747P1801X Nursing Service Related Providers Technician Personal Care Attendant 83 CTR BASED RESPITE CARE (IN-ST) 83 Respite Care 385H00000X Respite Care Facility Respite Care 85 ADLT DAY HLTH CA (WVR) 76 Adult Day Care 261QA0600X Ambulatory Health Care Facilities Clinic/Center Adult Day Care 85 ADLT DAY HLTH CA (WVR) 77 Habilitation 261QA0600X Ambulatory Health Care Facilities Clinic/Center Adult Day Care 86 ICF/DD NULL 261QR0400X Ambulatory Health Care Facilities/Clinic/Center, Rehabilitation 87 RURAL HLTH 94 Rural Health Clinic 261QR1300X Ambulatory Health Care Facilities/Clinic/Center, Rural Health 88 ICF/DD - GROUP HOME 86 Hospitals and Nursing Homes 261QD1600X Ambulatory Health Care Facilities Clinic/Center Developmental Disabilities 89 SPRVISE INDEP LIV (WVR)(IN-ST) 89 Supervised Living 372600000X Nursing Service Related Providers Adult Companion 90 CERTIFIED NURSE MIDWIFE 16 OB/GYN 367A00000X Physician Assistants & Advanced Practice Nursing Providers/Midwife, Certified Nurse 91 CERT REG NURS ANEST (IND & GP) 5 163W00000X Nursing Service Providers Registered Nurse
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx