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General NPI Number Information
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NPI Number | 1215197801
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Entity Type | Organization
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Legal Business Name | DAYBREAK ENTERPRISES
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 702 W KOENIG ST
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City | GRAND ISLAND
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State | NE
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Zip | 68801-6556
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Country | US
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Telephone | 308-381-0608
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 763
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City | GRAND ISLAND
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State | NE
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Zip | 68802-0763
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Country | US
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Telephone | 308-381-0608
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Fax |
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Authorized Official
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Title or Position | OWNER, DIRECTOR
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Name | MELISSA ADAMS
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Credential | LCSW
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Telephone | 308-381-0608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1140
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License Number State | NE
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