Provider Demographics
NPI:1225247299
Name:DAYBREAK COMMUNITY SERVICES
Entity Type:Organization
Organization Name:DAYBREAK COMMUNITY SERVICES
Other - Org Name:DAYBREAK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-447-2700
Mailing Address - Street 1:2505 S INTERSTATE 35 W
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-6139
Mailing Address - Country:US
Mailing Address - Phone:817-447-2700
Mailing Address - Fax:817-447-3033
Practice Address - Street 1:2505 S INTERSTATE 35 W
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-6139
Practice Address - Country:US
Practice Address - Phone:817-447-2700
Practice Address - Fax:817-447-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001360251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1001360OtherICF LICENSE
TX0001001360OtherCONTRACT #
TX003758OtherCONTRACT