MEDICARE: AVA HEALTH, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	324500000X	Substance Abuse Rehabilitation Facility
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1740079805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVA HEALTH, LLC

Provider Business Mailing Address
First Line	:	1646 S DEFRAME ST UNIT B8
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-6015
Country	:	US
Telephone Number	:	720-626-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2784 CROSSROADS BLVD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81506-8711
Country	:	US
Telephone Number	:	609-703-5006
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATION OFFICER
Name	:	MR. IAN GERSHMAN
Credential	:	MBA, MA
Telephone Number	:	609-703-5006

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	07/14/2025

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Directions to “AVA HEALTH, LLC ” Practice Location

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