Healthcare Provider Details

I. General information

NPI: 1033443288
Provider Name (Legal Business Name): DAYBREAK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2009
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 DEVONSHIRE DR
DESOTO TX
75115-3757
US

IV. Provider business mailing address

4150 INTERNATIONAL PLZ STE 820
FORT WORTH TX
76109-4836
US

V. Phone/Fax

Practice location:
  • Phone: 800-299-5161
  • Fax: 817-447-3033
Mailing address:
  • Phone: 817-289-8450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN PENKALA
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 817-289-8450