Provider Demographics
NPI:1831358878
Name:DEVELOPMENTAL OPPORTUNITIES
Entity type:Organization
Organization Name:DEVELOPMENTAL OPPORTUNITIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:MBA
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:2008-06-05
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO92875351251B00000X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09139601Medicaid
CO11620561Medicaid