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NPI Code Detail

MEDICARE: DAYBREAK HOME HEALTH NURSING SERVICES

MEDICARE: DAYBREAK HOME HEALTH NURSING SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility001007251TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376675322
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAYBREAK HOME HEALTH NURSING SERVICES
Provider Business Mailing Address
First Line : PO BOX 451485
Second Line :
City : HOUSTON
State : TX
Zip : 77245-1485
Country : US
Telephone Number : 713-433-0528
Fax Number : 713-433-1462
Provider Business Practice Location Address
First Line : 5331 W OREM DR
Second Line :
City : HOUSTON
State : TX
Zip : 77045-5036
Country : US
Telephone Number : 713-433-0528
Fax Number : 713-433-1462
Authorized Official
Title or Position : GENERAL PARTNER
Name : GWENDOLYN ARNETTA GIBBS
Credential :
Telephone Number : 713-433-0528
Provider Enumeration Date : 03/12/2007
Last Update Date : 09/04/2012

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Directions to “DAYBREAK HOME HEALTH NURSING SERVICES ” Practice Location

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