Healthcare Provider Details

I. General information

NPI: 1972173656
Provider Name (Legal Business Name): ECO ADVENTURES DAY PROGRAM AND RESPITE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2021
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 PETERSON ST APT 102
FORT COLLINS CO
80524-2964
US

IV. Provider business mailing address

301 PETERSON ST APT 102
FORT COLLINS CO
80524-2964
US

V. Phone/Fax

Practice location:
  • Phone: 970-224-2627
  • Fax:
Mailing address:
  • Phone: 970-224-2627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. MEADOW LYNN GISI
Title or Position: DIRECTOR/OWNER
Credential:
Phone: 970-224-2627