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General NPI Number Information
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NPI Number | 1891469938
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Entity Type | Organization
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Legal Business Name | THIRD WAY CENTER, INC
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 1133 LINCOLN ST
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City | DENVER
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State | CO
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Zip | 80203-2110
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Country | US
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Telephone | 303-832-6622
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 61385
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City | DENVER
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State | CO
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Zip | 80206-8385
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Country | US
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Telephone | 303-780-9191
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Fax |
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Authorized Official
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Title or Position | DATA OPERATIONS COORDINATOR
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Name | ERIN MARTIN
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Credential |
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Telephone | 303-780-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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