Provider Demographics
NPI:1316983976
Name:DAYBREAK COMMUNITY SERVICES
Entity type:Organization
Organization Name:DAYBREAK COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-447-2700
Mailing Address - Street 1:P. O. BOX 1775
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76097-1775
Mailing Address - Country:US
Mailing Address - Phone:817-447-2700
Mailing Address - Fax:817-447-2831
Practice Address - Street 1:2505 S. I35-WEST
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76097-1775
Practice Address - Country:US
Practice Address - Phone:817-447-2700
Practice Address - Fax:817-447-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005539251E00000X
TX007725251E00000X
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX007725OtherHCS LICENSE
TX005539OtherHCS LICENSE