| Dba Family Room Co.,stacey Horn, Lcsw | |
|
407 Broadway #2 Eagle CO 81631-6042 | |
| (970) 616-4401 | |
| (970) 616-4401 |
| Full Name | Dba Family Room Co.,stacey Horn, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 407 Broadway, Eagle, Colorado |
| Authorized Official Name and Position | Stacey Horn (THERAPIST) |
| Authorized Official Contact | 9706164401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dba Family Room Co.,stacey Horn, Lcsw Po Box 6042 Eagle CO 81631-6042 Ph: (970) 616-4401 | Dba Family Room Co.,stacey Horn, Lcsw 407 Broadway #2 Eagle CO 81631-6042 Ph: (970) 616-4401 |
| NPI Number | 1033437025 |
|---|---|
| Provider Enumeration Date | 05/14/2010 |
| Last Update Date | 05/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033437025 | NPI | - | NPPES |
| 38820773 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 639 (Colorado) | Primary |
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