Provider Demographics
NPI:1346856457
Name:DT DAYTON LLC
Entity Type:Organization
Organization Name:DT DAYTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-258-7227
Mailing Address - Street 1:310 E LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:77535-1805
Mailing Address - Country:US
Mailing Address - Phone:936-258-7227
Mailing Address - Fax:936-258-7223
Practice Address - Street 1:310 E LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TX
Practice Address - Zip Code:77535-1805
Practice Address - Country:US
Practice Address - Phone:936-258-7227
Practice Address - Fax:936-258-7223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility