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General NPI Number Information
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NPI Number | 1033007364
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL OPPORTUNITIES
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 517 N DIAMOND AVE
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City | CANON CITY
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State | CO
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Zip | 81212-2522
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Country | US
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Telephone | 719-275-1616
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Fax | 719-275-1616
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Provider Business Mailing Address
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Address Line | 700 S 8TH ST
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City | CANON CITY
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State | CO
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Zip | 81212-4906
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Country | US
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Telephone | 719-275-1616
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Fax | 719-275-1616
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Authorized Official
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Title or Position | CEO
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Name | BRYANA JO MARSICANO
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Credential |
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Telephone | 719-269-2213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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