Provider Demographics
NPI:1558065516
Name:LACUNA AUTISM SERVICES LLC
Entity Type:Organization
Organization Name:LACUNA AUTISM SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CREAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-399-0970
Mailing Address - Street 1:830 TENDERFOOT HILL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7372
Mailing Address - Country:US
Mailing Address - Phone:888-611-0870
Mailing Address - Fax:888-714-4996
Practice Address - Street 1:40 BURTON HILLS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-5902
Practice Address - Country:US
Practice Address - Phone:888-611-0870
Practice Address - Fax:888-714-4996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty