Provider Demographics
NPI:1790120764
Name:DAYBREAKS SENIOR CARE LLC
Entity Type:Organization
Organization Name:DAYBREAKS SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RIVA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:618-651-4120
Mailing Address - Street 1:1308 MERCANTILE DR STE A
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-1297
Mailing Address - Country:US
Mailing Address - Phone:618-651-4120
Mailing Address - Fax:618-651-4121
Practice Address - Street 1:1308 MERCANTILE DR STE A
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IL
Practice Address - Zip Code:62249-1297
Practice Address - Country:US
Practice Address - Phone:618-651-4120
Practice Address - Fax:618-651-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-05
Last Update Date:2013-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care