Healthcare Provider Details

I. General information

NPI: 1518809292
Provider Name (Legal Business Name): DAYBREAK VILLAGE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E 12TH ST
GREGORY SD
57533-1181
US

IV. Provider business mailing address

210 E 12TH ST
GREGORY SD
57533-1181
US

V. Phone/Fax

Practice location:
  • Phone: 605-835-9717
  • Fax:
Mailing address:
  • Phone: 605-835-9717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: RENEE M HOLZER
Title or Position: ACCOUNTANT
Credential:
Phone: 605-842-0806