Healthcare Provider Details

I. General information

NPI: 1366135550
Provider Name (Legal Business Name): SUMMIT LEARNING COLORADO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 S UNIVERSITY BLVD APT 414
DENVER CO
80210-5469
US

IV. Provider business mailing address

2200 S UNIVERSITY BLVD APT 414
DENVER CO
80210-5469
US

V. Phone/Fax

Practice location:
  • Phone: 858-692-0035
  • Fax:
Mailing address:
  • Phone: 858-692-0035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. LISA ANKENY
Title or Position: CLINICAL DIRECTOR/BEHAVIOR ANALYST
Credential: BCBA
Phone: 858-692-0035