Healthcare Provider Details

I. General information

NPI: 1801429311
Provider Name (Legal Business Name): DEVELOPMENTAL SERVICES AND CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2020
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12009 NE 99TH ST STE 1430
VANCOUVER WA
98682-2497
US

IV. Provider business mailing address

12009 NE 99TH ST STE 1430
VANCOUVER WA
98682-2497
US

V. Phone/Fax

Practice location:
  • Phone: 360-524-2144
  • Fax:
Mailing address:
  • Phone: 360-984-8047
  • 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 Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY ROBERTS
Title or Position: AGENCY DIRECTOR
Credential: M.S., BCBA, LBA
Phone: 951-533-6622