Healthcare Provider Details

I. General information

NPI: 1588106413
Provider Name (Legal Business Name): MILESTONES DEVELOPMENTAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 05/15/2020
Certification Date: 05/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1499 W 120TH AVE STE 110
WESTMINSTER CO
80234-2719
US

IV. Provider business mailing address

1499 W 120TH AVE STE 110
WESTMINSTER CO
80234-2719
US

V. Phone/Fax

Practice location:
  • Phone: 720-602-4220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LIBBY R SCHELLENBERG-SKINAS
Title or Position: CEO/ BEHAVIOR ANALYST
Credential: M.S., BCBA
Phone: 303-990-0665