Healthcare Provider Details

I. General information

NPI: 1740048891
Provider Name (Legal Business Name): DAYBREAK COUNCELORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 OFFICE COURT DR STE 403
SANTA FE NM
87507-4906
US

IV. Provider business mailing address

4737 HIGHLANDS LOOP
SANTA FE NM
87507-4601
US

V. Phone/Fax

Practice location:
  • Phone: 505-395-9456
  • Fax:
Mailing address:
  • Phone: 417-894-0261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: HAL AGLER
Title or Position: OWNER
Credential: LCSW
Phone: 54-705-2725