Organization
GREENBREAK, INC.
Active
Other names
Daybreak
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA TODD (OPERATIONS BUSINESS MANAGER)
(800) 299-5161
Entity
Organization
Contact information
Practice address
219 VALLEYGLEN DR, DESOTO, TX 75115-5735
(800) 299-5161
(817) 447-3033
Mailing address
4800 OVERTON PLZ STE 440, FORT WORTH, TX 76109-4435
(800) 299-5161
(817) 447-3033
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000389002
CONTRACT #
TX
01
—
116243
LICENSE
TX
01
—
389002
CONTRACT
TX
Enumeration date
05/31/2007
Last updated
12/07/2020
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