Provider Demographics
NPI:1639719552
Name:DAYBREAK, INC.
Entity Type:Organization
Organization Name:DAYBREAK, INC.
Other - Org Name:1622 WILLOW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE OFFICE & PROJECT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-299-5161
Mailing Address - Street 1:4800 OVERTON PLZ STE 440
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4435
Mailing Address - Country:US
Mailing Address - Phone:800-299-5161
Mailing Address - Fax:817-447-3033
Practice Address - Street 1:1622 WILLOW LN
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5255
Practice Address - Country:US
Practice Address - Phone:830-629-4400
Practice Address - Fax:830-609-0208
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAYBREAK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities