| Name | Value |
|---|---|
| PROVIDER TYPE | Nursing & Custodial Care Facilities |
| CLASSIFICATION | Intermediate Care Facility, Mentally Retarded |
| DEFINITION | (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| STATUS | Active |
| X12 CODE | 315P00000X |
| INDIVIDUAL/NON | NON-INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5252780 |
| EFFECTIVE DATE/TIME |
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