Provider Demographics
NPI:1568160372
Name:AVANTI BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:AVANTI BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-502-7117
Mailing Address - Street 1:5950 S WILLOW DR STE 308
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-5177
Mailing Address - Country:US
Mailing Address - Phone:720-753-5715
Mailing Address - Fax:
Practice Address - Street 1:AVANTI BEHAVIORAL HEALTH
Practice Address - Street 2:5950 S. WILLOW DR SUITE 308
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:720-753-5715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health