Provider Demographics
NPI:1922343730
Name:DAYBREAK FAMILY COUNSELING ENTERPRISES INCORPORATED
Entity Type:Organization
Organization Name:DAYBREAK FAMILY COUNSELING ENTERPRISES INCORPORATED
Other - Org Name:VILLAGE COUNSELING AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZETTE
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:BRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:818-238-9895
Mailing Address - Street 1:4405 W RIVERSIDE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4072
Mailing Address - Country:US
Mailing Address - Phone:818-238-9895
Mailing Address - Fax:818-238-9896
Practice Address - Street 1:4405 W RIVERSIDE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4072
Practice Address - Country:US
Practice Address - Phone:818-238-9895
Practice Address - Fax:818-238-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37518101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty