Daybreak Youth Services
Counselor, Mental Health in Vancouver, WA. Organization (NPI-2).
Details
- NPI
- 1003199712
- Entity type
- Organization (NPI-2)
- Legal business name
- Daybreak Youth Services
- Organization subpart
- Yes
- Enumeration date
- Sep 20, 2011
- Certification date
- Sep 22, 2022
- Last updated
- Sep 22, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 06155400 | WA | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 06155400 | WA | |
| 251B00000X | Case Management | 06155400 | WA |
Other names
- Daybreak Vancouver Outpatient (Doing Business As)
Practice location
11818 Se Mill Plain BlvdSuite 307
Vancouver, WA 98684
Phone 360-750-9635 · Fax 360-334-9541
Mailing address
960 E 3rd AveSpokane, WA 99202-2241
Phone 509-444-7033 · Fax 509-927-1851
Authorized official
Thomas Russell
Ceo
5094447033
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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