PREMIUM NATION ENTERPRISE LLC

Community/Behavioral Health

Code: 251S00000X

In Home Supportive Care

Code: 253Z00000X

Clinic/Center — Adult Day Care

Code: 261QA0600X

Clinic/Center — Developmental Disabilities

Code: 261QD1600X

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

Code: 261QM0801X

Clinic/Center — Adult Mental Health

Code: 261QM0850X

Assisted Living Facility — Assisted Living, Behavioral Disturbances

Code: 3104A0630X

Intermediate Care Facility, Intellectual Disabilities

Code: 315P00000X

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Code: 320600000X

Community Based Residential Treatment Facility, Mental Illness

Code: 320800000X

Day Training, Developmentally Disabled Services

Code: 251C00000X