Provider Demographics
NPI:1447587860
Name:DAYBREAK EQUESTRIAN CENTER LLC
Entity Type:Organization
Organization Name:DAYBREAK EQUESTRIAN CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRSITY
Authorized Official - Middle Name:PECK
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:HMC
Authorized Official - Phone:702-430-6206
Mailing Address - Street 1:PO BOX 235
Mailing Address - Street 2:
Mailing Address - City:LUND
Mailing Address - State:NV
Mailing Address - Zip Code:89317-0235
Mailing Address - Country:US
Mailing Address - Phone:702-430-6206
Mailing Address - Fax:775-549-8800
Practice Address - Street 1:157 SUNNY SIDE LANE
Practice Address - Street 2:
Practice Address - City:LUND
Practice Address - State:NV
Practice Address - Zip Code:89317
Practice Address - Country:US
Practice Address - Phone:702-430-6206
Practice Address - Fax:775-549-8800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty