MEDICARE: ADVENTURE LEARNING BEHAVIORAL INTERVENTIONS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	385HR2055X	Child Mental Illness Respite Care
3	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
4	385H00000X	Respite Care

General Provider Information

NPI Number	:	1518620673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVENTURE LEARNING BEHAVIORAL INTERVENTIONS

Provider Business Mailing Address
First Line	:	5423 SPOKED WHEEL DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-8741
Country	:	US
Telephone Number	:	719-354-5297
Fax Number	:

Provider Business Practice Location Address
First Line	:	1706 N CIRCLE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-2409
Country	:	US
Telephone Number	:	719-354-5297
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ASHLEY BALLARD
Credential	:
Telephone Number	:	719-354-5297

Provider Enumeration Date	:	10/15/2021
Last Update Date	:	10/15/2021

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