BENJAMIN OUTREACH MEDICAL NETWORK CORPORATION

Psychologist — Family

Code: 103TF0000X

Psychologist — Group Psychotherapy

Code: 103TP2701X

Community/Behavioral Health

Code: 251S00000X

Clinic/Center — Community Health

Code: 261QC1500X

Clinic/Center — Mental Health (Including Community Mental Health Center)

Code: 261QM0801X

Psychologist — Adult Development & Aging

Code: 103TA0700X

Clinic/Center — Primary Care

Code: 261QP2300X

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

Code: 320900000X

Clinic/Center — Health Service

Code: 261QH0100X