Provider Demographics
NPI:1528643566
Name:FAMILY DYNAMICS, LLC
Entity type:Organization
Organization Name:FAMILY DYNAMICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HACKMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-261-2633
Mailing Address - Street 1:77 CHOKE CHERRY CIR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-7535
Mailing Address - Country:US
Mailing Address - Phone:970-261-2633
Mailing Address - Fax:
Practice Address - Street 1:2243 MAIN AVE STE 17
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4699
Practice Address - Country:US
Practice Address - Phone:970-261-2633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty