Healthcare Provider Details

I. General information

NPI: 1811812126
Provider Name (Legal Business Name): GRAVA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13903 WILD LUPINE ST
PARKER CO
80134-4667
US

IV. Provider business mailing address

13903 WILD LUPINE ST
PARKER CO
80134-4667
US

V. Phone/Fax

Practice location:
  • Phone: 925-330-6148
  • Fax:
Mailing address:
  • Phone: 925-330-6148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE A STEVENS
Title or Position: CO-FOUNDER
Credential: LAC, LPCC
Phone: 925-330-6148