Daybreak, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

DAYBREAK, INC.

Doing business as

4801 Bermuda Dr

Practice address

4801 Bermuda Dr
San Angelo, TX 76904-7204

Phone

(877) 659-3108

Fax

(325) 657-9237

NPI assigned

Jan 10, 2020

Organization subpart

Yes

Parent organization

DAYBREAK, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathryn Penkala

Title

Director of Credentialing

Phone

(817) 289-8450

Specialties & licenses 2

Addresses

Other names 1

• 4801 Bermuda Dr Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033759758. Details of each certification follow.

• CCN 45G202 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 45G202

Legal name

4801 BERMUDA DR

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jun 11, 1986

Last certification

Apr 29, 2025

Beds

6

Ownership / control type

Private (proprietary)

Facility address

4801 Bermuda Dr.
San Angelo, TX 76904

Tax ID family

Daybreak Inc26 organizations share this tax ID, including this one

Part of

Daybreak Inc

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

• Daybreak, Inc.

  dba Devonshire Home

  • Intellectual Disabilities Intermediate Care Facility
  • Desoto, TX
  • NPI 1033443288
  NPD tax ID
• Daybreak, Inc.

  dba 3221 Southland Blvd

  • Intellectual Disabilities Intermediate Care Facility
  • San Angelo, TX
  • NPI 1053951764
  NPD tax ID
• Daybreak, Inc.

  dba 1809 Auburn

  • Intellectual Disabilities Intermediate Care Facility
  • Richardson, TX
  • NPI 1053951772
  NPD tax ID
• Daybreak, Inc.

  dba Prairie Creek

  • Intellectual Disabilities Intermediate Care Facility
  • Desoto, TX
  • NPI 1073714507
  NPD tax ID
• Daybreak, Inc.

  dba Daybreak

  • Intellectual Disabilities Intermediate Care Facility
  • Desoto, TX
  • NPI 1104036771
  NPD tax ID
• Daybreak, Inc.

  dba 2100 Cedar

  • Intellectual Disabilities Intermediate Care Facility
  • Carrollton, TX
  • NPI 1124668850
  NPD tax ID
• Daybreak, Inc.

  dba 1509 Versailles

  • Intellectual Disabilities Intermediate Care Facility
  • Richardson, TX
  • NPI 1245870161
  NPD tax ID
• Daybreak, Inc.

  dba Amicus at Rifleman

  • Intellectual Disabilities Intermediate Care Facility
  • Arlington, TX
  • NPI 1255519468
  NPD tax ID
• Daybreak, Inc.

  dba Amicus at Xavier

  • Intellectual Disabilities Intermediate Care Facility
  • Arlington, TX
  • NPI 1275640666
  NPD tax ID
• Daybreak, Inc.

  dba 2742 Palo Duro Dr

  • Intellectual Disabilities Intermediate Care Facility
  • San Angelo, TX
  • NPI 1285274126
  NPD tax ID
• Daybreak, Inc.

  dba 974 E Cedar

  • Intellectual Disabilities Intermediate Care Facility
  • Seguin, TX
  • NPI 1295375913
  NPD tax ID
• Daybreak, Inc.

  dba 6520 Braddock Place

  • Intellectual Disabilities Intermediate Care Facility
  • Dallas, TX
  • NPI 1306446000
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1033759758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 INTERNATIONAL PLZ STE 820",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094836",
            "telephone_number": "817-289-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 BERMUDA DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047204",
            "telephone_number": "877-659-3108",
            "fax_number": "325-657-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYBREAK, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAYBREAK, INC.",
        "enumeration_date": "2020-01-10",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "PENKALA",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "817-289-8450"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4801 Bermuda Dr",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "4801 Bermuda Dr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Min Davison, LCSW
• Debra Ruth Dawkins, M. ED.
• Mona M Dawson, GNP
• Matthew Day, LAT,ATC
• Walter G Day, M.D.
• Daybreak, Inc. (3221 Southland Blvd)
• Daybreak, Inc. (2742 Palo Duro Dr)
• Daybreak, Inc. (3217 Clearview Dr)
• Daybreak, Inc. (Sierra House)
• Max Dayton

• Intellectual Disabilities Intermediate Care Facility in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Intellectual Disabilities Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.