Daybreak Vancouver Outpatient
LBN: Daybreak Youth Services
Daybreak Vancouver Outpatient is an health care organization with primary practice located at 11818 Se Mill Plain Blvd Suite 307, Vancouver WA 98684. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Agencies / Case Management. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty.
Daybreak Youth Services can be contacted via phone (360) 750-9635, or through Russell, Thomas via phone (509) 444-7033.
Contact Information
Primary practice address
11818 Se Mill Plain Blvd Suite 307
Vancouver WA 98684
Phone: (360) 750-9635
Fax: (360) 334-9541
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 06155400 | Washington |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 06155400 | Washington |
| Agencies / Case Management | 251B00000X | 06155400 | Washington |
Profile Details
| NPI number | 1003199712 |
|---|---|
| LBN Legal business name | Daybreak Youth Services |
| DBA Doing business as | Daybreak Vancouver Outpatient |
| Authorized official | Russell, Thomas |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Sep 20th, 2011 |
| Last updated | Sep 22nd, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003199712 | NPPES |
| Washington | MEDICAID | 2015313 | |
| Washington | Other | 155400 |
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