MEDICARE: DAYBREAK REHABILITATION CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1881872414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAYBREAK REHABILITATION CENTER, INC.

Provider Business Mailing Address
First Line	:	PO BOX 268
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-0268
Country	:	US
Telephone Number	:	281-208-2702
Fax Number	:	281-208-8340

Provider Business Practice Location Address
First Line	:	4630 BRAZOS BEND DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4058
Country	:	US
Telephone Number	:	281-208-2702
Fax Number	:	281-208-8340

Authorized Official
Title or Position	:	REGISTERED AGENT
Name	:	GWENDOLYN A GIBBS
Credential	:
Telephone Number	:	832-818-4443

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	02/06/2008

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