NPIMap

Organization Active NPI

Daybreak Youth Services

  • Children's Substance Abuse Rehabilitation Facility
  • Brush Prairie, WA
National Provider Identifier
1306851175
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
License
200451 Issued in WA
Legal business name
DAYBREAK YOUTH SERVICES
Practice address
11910 NE 154TH St
Brush Prairie, WA 98606
Phone
(360) 750-9588
Fax
(509) 459-3920
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Authorized official

Name
Mr. Thomas Russell
Title
Ceo
Phone
(509) 444-7033

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X
Children's Substance Abuse Rehabilitation Facility 3245S0500X 200451 WA Primary

Addresses

Primary practice location

11910 NE 154TH St
Brush Prairie, WA 98606

Mailing address

960 E 3Rd Ave
Spokane, WA 99202-2241
Phone (509) 444-7033

Other identifiers 2

IdentifierTypeStateIssuer
200451OtherWAWA STATE DBHR
1007226MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Daybreak Youth Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1306851175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 E 3RD AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022241",
            "telephone_number": "509-444-7033",
            "fax_number": "509-927-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11910 NE 154TH ST",
            "city": "BRUSH PRAIRIE",
            "state": "WA",
            "postal_code": "98606",
            "telephone_number": "360-750-9588",
            "fax_number": "509-459-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYBREAK YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-444-7033",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "WA",
            "license": "200451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DBHR",
            "identifier": "200451",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007226",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brush Prairie, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.