DAYBREAK CANYON LLC (NPI# 1568758720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568758720 |
| Entity Type | Organization |
| Organization Name | DAYBREAK CANYON LLC |
| Practice Address |
1229 Country Club Rd. Kellogg ID 83837 |
| Practice Telephone | 2087841433 |
| Practice Fax Number | 8775803806 |
| Mailing Telephone | 2087841433 |
| Mailing Fax Number | 8775803806 |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2016-03-18 |
| Authorized Official Name | MR. LAURENCE D MCARTHUR (MEMBER, CEO) |
| Authorized Official Telephone | 2083124117 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 31306 | ID | Residential Treatment Facilities |
| Street Address |
1229 COUNTRY CLUB RD. |
| City | KELLOGG |
| State | ID |
| Zip Code | 83837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740632983 | Jessica Croston | Non-emergency Medical Transport (VAN) | 12 Slaughter House Gul, Wardner, Kellogg, ID 83837 | 2016-07-12 |
| 1295034684 | Rusty M Wood | Physical Therapist | 704 Mckinley Avenue, Kellogg, ID 83837 | 2011-03-24 |
| 1295914760 | Silver Valley Emergency Physicians | Emergency Medicine | 3 Jacobs Gulch Road, Kellogg, ID 83837 | 2007-10-31 |
| 1629117429 | Community Ambulance Service Inc | Ambulance | 124 W Brown, Kellogg, ID 83837 | 2007-02-06 |
| 1396810255 | Steven Joseph Rinaldi | Dentist | 418 W Cameron Ave, Kellogg, ID 83837 | 2006-11-22 |
| 1760576193 | Kellogg Drugs LLC | Pharmacy | 131 West Cameron Ave, Kellogg, ID 83837 | 2006-10-02 |
| 1578654406 | Neil Orlew Norman | Dentist | 302 E Cameron Ave, Kellogg, ID 83837 | 2006-09-27 |
| 1285677278 | Loren Ken Zeitz | Anesthesiology | 25 Jacobs Gulch, Kellogg, ID 83837 | 2006-06-14 |
| 1962981951 | Joanne Elizabeth Swiatek | Occupational Therapist | 25 Jacobs Gulch Rd, Kellogg, ID 83837 | 2018-08-09 |
| 1972089605 | Kathleen Nansel | Rehabilitation Practitioner | 740 Mckinley Ave, Kellogg, ID 83837 | 2018-07-16 |
| Find all providers in zip 83837 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376935494 | Apex Adventure Therapy | Residential Treatment Facility, Emotionally Disturbed Children | 1832 E 1750 S, Gooding, ID 83330-5177 | 2015-02-26 |
| 1952738262 | Idaho Youth Ranch | Residential Treatment Facility, Emotionally Disturbed Children | 5465 W Irving St, Boise, ID 83706-1213 | 2013-10-01 |
| 1073843868 | Sequel Tsi of Idaho, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2850 Industrial Way, Mountain Home, ID 83647-3960 | 2009-12-30 |
| 1619119864 | Ahs of Idaho | Residential Treatment Facility, Emotionally Disturbed Children | 911 Preacher Creek Rd, Shoshone, ID 83352-5061 | 2009-04-02 |
| 1235758897 | Hawks Landing of Idaho LLC | Residential Treatment Facility, Emotionally Disturbed Children | 222 Nighthawk Rd, Bonners Ferry, ID 83805-5441 | 2020-04-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.