Provider Demographics
NPI:1225263593
Name:THIRD WAY CENTER, INC.
Entity Type:Organization
Organization Name:THIRD WAY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:EISNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:303-780-9191
Mailing Address - Street 1:PO BOX 61385
Mailing Address - Street 2:LOWRY SPROUT
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-8385
Mailing Address - Country:US
Mailing Address - Phone:303-780-9191
Mailing Address - Fax:303-780-9192
Practice Address - Street 1:9100 E LOWRY BLVD
Practice Address - Street 2:LOWRY SPROUT
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6935
Practice Address - Country:US
Practice Address - Phone:303-780-9188
Practice Address - Fax:720-859-7703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1547437322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children