Provider Demographics
NPI:1366010654
Name:COLORADO AUTISM CONSULTANTS, LLC
Entity Type:Organization
Organization Name:COLORADO AUTISM CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-550-0489
Mailing Address - Street 1:PO BOX 4804
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81211-4804
Mailing Address - Country:US
Mailing Address - Phone:505-550-0489
Mailing Address - Fax:303-975-2251
Practice Address - Street 1:10650 E BETHANY DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2653
Practice Address - Country:US
Practice Address - Phone:719-584-8055
Practice Address - Fax:303-957-2251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000141116Medicaid