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NPI Code Detail

MEDICARE: THIRD WAY CENTER, INC

MEDICARE: THIRD WAY CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750054680
Entity Type Code : Organization
Provider Name (Legal Business Name) : THIRD WAY CENTER, INC
Provider Business Mailing Address
First Line : PO BOX 61385
Second Line :
City : DENVER
State : CO
Zip : 80206-8385
Country : US
Telephone Number : 303-780-9191
Fax Number : 303-780-9192
Provider Business Practice Location Address
First Line : 1295 YORK ST
Second Line :
City : DENVER
State : CO
Zip : 80206-3008
Country : US
Telephone Number : 303-780-9191
Fax Number :
Authorized Official
Title or Position : DATA OPERATIONS COORDINATOR
Name : ERIN MARTIN
Credential :
Telephone Number : 303-780-9191
Provider Enumeration Date : 07/27/2021
Last Update Date : 07/27/2021

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Directions to “THIRD WAY CENTER, INC ” Practice Location

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