Provider Demographics
NPI:1013175264
Name:DEVELOPMENTAL OPPORTUNITIES
Entity Type:Organization
Organization Name:DEVELOPMENTAL OPPORTUNITIES
Other - Org Name:STARPOINT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRYANA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MARSICANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-269-2213
Mailing Address - Street 1:PO BOX 2080
Mailing Address - Street 2:700 S 8TH STREET
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81215-2080
Mailing Address - Country:US
Mailing Address - Phone:719-275-1616
Mailing Address - Fax:719-275-4619
Practice Address - Street 1:700 S 8TH STREET
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-4904
Practice Address - Country:US
Practice Address - Phone:719-275-1616
Practice Address - Fax:719-275-4619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO95138340251B00000X
251C00000X, 252Y00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No252Y00000XAgenciesEarly Intervention Provider Agency
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09139601Medicaid
CO11620561Medicaid