Provider Demographics
NPI:1841813045
Name:WINDHORSE ELDER & FAMILY CARE, INC
Entity type:Organization
Organization Name:WINDHORSE ELDER & FAMILY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COUNSELING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:303-390-1645
Mailing Address - Street 1:6640 GUNPARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-7001
Mailing Address - Country:US
Mailing Address - Phone:303-786-9313
Mailing Address - Fax:
Practice Address - Street 1:6640 GUNPARK DR STE 100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-7001
Practice Address - Country:US
Practice Address - Phone:303-786-9313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty