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General NPI Number Information
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NPI Number | 1972173656
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Entity Type | Organization
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Legal Business Name | ECO ADVENTURES DAY PROGRAM AND RESPITE LLC
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Dates
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Enumeration Date | 06/25/2021
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 301 PETERSON ST APT 102
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City | FORT COLLINS
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State | CO
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Zip | 80524-2964
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Country | US
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Telephone | 970-224-2627
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Fax |
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Provider Business Mailing Address
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Address Line | 301 PETERSON ST APT 102
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City | FORT COLLINS
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State | CO
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Zip | 80524-2964
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Country | US
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Telephone | 970-224-2627
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MS. MEADOW LYNN GISI
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Credential |
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Telephone | 970-224-2627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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