Healthcare Provider Details

I. General information

NPI: 1487294302
Provider Name (Legal Business Name): DAYBREAK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2020
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3706 CARTER CREEK PKWY
BRYAN TX
77802-3229
US

IV. Provider business mailing address

4800 OVERTON PLZ STE 440
FORT WORTH TX
76109-4435
US

V. Phone/Fax

Practice location:
  • Phone: 888-775-5135
  • Fax: 979-695-7063
Mailing address:
  • Phone: 800-299-5161
  • Fax: 817-447-3033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: ANNA TODD
Title or Position: CORPORATE OFFICE & PROJECT MANAGER
Credential:
Phone: 800-299-5161