NPIMap

Organization Active NPI

Daybreak Behavioral Resources, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Flagstaff, AZ
National Provider Identifier
1881878460
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
DDH1715 Issued in AZ
Legal business name
DAYBREAK BEHAVIORAL RESOURCES, LLC
Practice address
6070 E Treadway TRL
Flagstaff, AZ 86004-1029
Phone
(928) 526-1499
Fax
(928) 526-1151
NPI assigned
Dec 19, 2007
Last updated
Dec 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Authorized official

Name
Mr. Thomas W Kenny
Title
Ceo
Phone
(928) 526-0779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X DDH1715 AZ Primary

Addresses

Primary practice location

6070 E Treadway TRL
Flagstaff, AZ 86004-1029

Mailing address

6070 E Treadway TRL
Flagstaff, AZ 86004-1029
Phone (928) 526-1499

Other identifiers 1

IdentifierTypeStateIssuer
DDH17158OtherAZLICENSE

Other names 1

  • Kaitlin Ranch Other name

National Provider Directory

National Provider Directory
Tax ID family
Brighter Heights Arizona LLC Dba Blue Ridge Manor15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1881878460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 E TREADWAY TRL",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041029",
            "telephone_number": "928-526-1499",
            "fax_number": "928-526-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 E TREADWAY TRL",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041029",
            "telephone_number": "928-526-1499",
            "fax_number": "928-526-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYBREAK BEHAVIORAL RESOURCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "KENNY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-526-0779",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AZ",
            "license": "DDH1715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DDH17158",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaitlin Ranch",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.