| Lacuna Inc | |
|
112 Alexander St # B Taos NM 87571-6278 | |
| (505) 770-6713 | |
| (505) 751-7231 |
| Full Name | Lacuna Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 112 Alexander St # B, Taos, New Mexico |
| Authorized Official Name and Position | Natalie Rae Carlton (CEO OF LACUNA) |
| Authorized Official Contact | 5057513565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lacuna Inc 7479 Ndcbu Taos NM 87571-6177 Ph: (505) 770-6713 | Lacuna Inc 112 Alexander St # B Taos NM 87571-6278 Ph: (505) 770-6713 |
| NPI Number | 1982817672 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982817672 | NPI | - | NPPES |
| NM100657 | Other | NM | VALUE OPTION PROVIDER NUM |
| A0211 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4519 (New Mexico) | Primary |
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