Organization
DAYBREAK BEHAVIORAL RESOURCES, LLC
Active
Organization
DAYBREAK BEHAVIORAL RESOURCES, LLC
Active
Other names
Kaitlin Ranch
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS W KENNY (CEO)
(928) 526-0779
Entity
Organization
Contact information
Practice address
6070 E TREADWAY TRL, FLAGSTAFF, AZ 86004-1029
(928) 526-1499
(928) 526-1151
Mailing address
6070 E TREADWAY TRL, FLAGSTAFF, AZ 86004-1029
(928) 526-1499
(928) 526-1151
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
DDH1715
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DDH17158
LICENSE
AZ
Enumeration date
12/19/2007
Last updated
12/19/2007
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