Provider Demographics
NPI:1164634242
Name:FOOTSTEPS INTO HEALTH, INC,
Entity Type:Organization
Organization Name:FOOTSTEPS INTO HEALTH, INC,
Other - Org Name:DAYBREAK ADHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:GIO
Authorized Official - Last Name:CORZO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:909-920-1165
Mailing Address - Street 1:268 MCARTHUR WAY
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786
Mailing Address - Country:US
Mailing Address - Phone:909-920-1165
Mailing Address - Fax:909-949-3800
Practice Address - Street 1:268 MCARTHUR WAY
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786
Practice Address - Country:US
Practice Address - Phone:909-920-1165
Practice Address - Fax:909-949-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service