Provider Demographics
NPI:1972173656
Name:ECO ADVENTURES DAY PROGRAM AND RESPITE LLC
Entity Type:Organization
Organization Name:ECO ADVENTURES DAY PROGRAM AND RESPITE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MEADOW
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-224-2627
Mailing Address - Street 1:PO BOX 272047
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80527-2047
Mailing Address - Country:US
Mailing Address - Phone:970-224-2627
Mailing Address - Fax:
Practice Address - Street 1:1843 ANGELO CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-6375
Practice Address - Country:US
Practice Address - Phone:970-224-2627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty