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General NPI Number Information
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NPI Number | 1881714368
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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 | 03/30/2007
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 1339 ELM AVE
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City | CANON CITY
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State | CO
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Zip | 81212-4431
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Country | US
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Telephone | 719-269-2251
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Fax | 719-269-2251
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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 | 719-269-2213
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Authorized Official
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Title or Position | CEO
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Name | MRS. 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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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