Healthcare Provider Details

I. General information

NPI: 1760391593
Provider Name (Legal Business Name): LACUNA AUTISM SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 LEFTHAND CIR STE A
LONGMONT CO
80501-6783
US

IV. Provider business mailing address

830 TENDERFOOT HILL RD
COLORADO SPRINGS CO
80906-2314
US

V. Phone/Fax

Practice location:
  • Phone: 888-611-0870
  • Fax: 888-714-4996
Mailing address:
  • Phone: 888-611-0870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SAYDRA STARKS
Title or Position: NATIONAL REVENUE CYCLE MANAGER
Credential:
Phone: 888-611-0870