# GRAND VALLEY SURGICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942207196
- **Authorized official:** MITCHELL SCHWARZBACH (ADMINISTRATOR)
- **Authorized official phone:** (970) 298-7822

## Contact information

- **Practice address:** 710 WELLINGTON AVE STE 21, GRAND JUNCTION, CO 81501-6102
- **Practice address phone:** (970) 298-7800
- **Practice address fax:** (970) 298-7850
- **Mailing address:** 710 WELLINGTON AVE STE 21, GRAND JUNCTION, CO 81501-6102
- **Mailing address phone:** (970) 298-7800
- **Mailing address fax:** (970) 298-7850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 1611ND | CO | Yes |

## Other

- **Enumeration date:** 07/01/2005
- **Last updated:** 09/11/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1611ND | STATE OF COLORADO DEPT OF PUBLIC HEALTH AND ENVIRONMENT ASC LICENSE | CO |
| 05 | — | 25273388 | — | CO |