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	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	251S00000X	Community/Behavioral Health Agency
5	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1760080386
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	:	719-314-8739
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	:	BCBA
Telephone Number	:	719-314-8739

Provider Enumeration Date	:	10/15/2020
Last Update Date	:	09/18/2024

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