Organization
DAYBREAK YOUTH SERVICES
Active
Parent organization
DAYBREAK YOUTH SERVICES
Other names
Daybreak Vancouver Outpatient
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAYBREAK YOUTH SERVICES
Authorized official
MR. THOMAS RUSSELL (CEO)
(509) 444-7033
Entity
Organization
Contact information
Practice address
11818 SE MILL PLAIN BLVD, SUITE 307, VANCOUVER, WA 98684
(360) 750-9635
(360) 334-9541
Mailing address
960 E 3RD AVE, SPOKANE, WA 99202-2241
(509) 444-7033
(509) 927-1851
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
06155400
WA
101YM0800X
Mental Health Counselor
Primary
06155400
WA
251B00000X
Case Management Agency
06155400
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
155400
WA STATE DBHR
WA
05
—
2015313
—
WA
Enumeration date
09/20/2011
Last updated
09/22/2022
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