Provider Demographics
NPI:1699247726
Name:DAYBREAK SENIOR SERVICES, LLC
Entity type:Organization
Organization Name:DAYBREAK SENIOR SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:AUGUST
Authorized Official - Last Name:LARSSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-230-7203
Mailing Address - Street 1:2171 N 3900 W
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84404-9713
Mailing Address - Country:US
Mailing Address - Phone:801-230-7203
Mailing Address - Fax:
Practice Address - Street 1:1351 VALLEY DR
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-0847
Practice Address - Country:US
Practice Address - Phone:801-823-0160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care