MEDICARE: MOUNTAIN VALLEY DEVELOPMENTAL SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1013480672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNTAIN VALLEY DEVELOPMENTAL SERVICES

Provider Business Mailing Address
First Line	:	700 MOUNT SOPRIS DR
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-4622
Country	:	US
Telephone Number	:	970-945-2306
Fax Number	:	970-945-6469

Provider Business Practice Location Address
First Line	:	1207 GRAND AVE
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-3870
Country	:	US
Telephone Number	:	970-945-2306
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	SARA NICOLE SIMS
Credential	:
Telephone Number	:	970-945-2306

Provider Enumeration Date	:	01/07/2019
Last Update Date	:	10/16/2025

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