# DAYBREAK YOUTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DAYBREAK YOUTH SERVICES
- **Other names:** Daybreak Vancouver Outpatient
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003199712
- **Legal business name:** DAYBREAK YOUTH SERVICES
- **Authorized official:** MR. THOMAS RUSSELL (CEO)
- **Authorized official phone:** (509) 444-7033

## Contact information

- **Practice address:** 11818 SE MILL PLAIN BLVD, SUITE 307, VANCOUVER, WA 98684
- **Practice address phone:** (360) 750-9635
- **Practice address fax:** (360) 334-9541
- **Mailing address:** 960 E 3RD AVE, SPOKANE, WA 99202-2241
- **Mailing address phone:** (509) 444-7033
- **Mailing address fax:** (509) 927-1851

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 06155400 | WA | — |
| 101YM0800X | Mental Health Counselor | 06155400 | WA | Yes |
| 251B00000X | Case Management Agency | 06155400 | WA | — |

## Other

- **Enumeration date:** 09/20/2011
- **Last updated:** 09/22/2022