IHOMA HEALTHCARE

Clinic/Center — Developmental Disabilities

Code: 261QD1600X

Registered Nurse

Code: 163W00000X

Licensed Practical Nurse

Code: 164W00000X

Physical Therapist

Code: 225100000X

Occupational Therapist

Code: 225X00000X

Local Education Agency (LEA)

Code: 251300000X

Case Management

Code: 251B00000X

Day Training, Developmentally Disabled Services

Code: 251C00000X

Home Health

Code: 251E00000X

Intermediate Care Facility, Mental Illness

Code: 310500000X

Intermediate Care Facility, Intellectual Disabilities

Code: 315P00000X

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Code: 320600000X

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Code: 320900000X

Non-emergency Medical Transport (VAN)

Code: 343900000X

Day Training/Habilitation Specialist

Code: 373H00000X