MEDICARE: GRAND ADVENTURES THERAPY SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1699603225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRAND ADVENTURES THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	4333 CORBETT DR # 1039
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-6111
Country	:	US
Telephone Number	:	970-239-1316
Fax Number	:

Provider Business Practice Location Address
First Line	:	2813 SECCOMB ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6211
Country	:	US
Telephone Number	:	970-239-1316
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRISTINE AMY ELMORE
Credential	:	M.S., SLP
Telephone Number	:	970-239-1316

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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Directions to “GRAND ADVENTURES THERAPY SERVICES LLC ” Practice Location

Language	Start Address	Practice Location

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