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Greenbreak, Inc.
Intellectual Disabilities Intermediate Care Facility in Desoto, Texas
NPI 1366643819

Greenbreak, Inc. is a Intellectual Disabilities Intermediate Care Facility based in Fort Worth, TX. Greenbreak, Inc. practices in Desoto, TX. The NPI Number for Greenbreak, Inc. is 1366643819 and holds a License No. (Texas).

The current practice location address for Greenbreak, Inc. is 219 Valleyglen Dr, Desoto, TX and can be reached out via phone at 800-299-5161 and via fax at 817-447-3033.

Location: 219 Valleyglen Dr, Desoto, TX, 76109-4435
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1366643819
Provider Name
Greenbreak, Inc.
Credential
Provider Entity Type
Organization
Address
219 Valleyglen Dr, Desoto, TX, 76109-4435
Phone Number
800-299-5161
Fax Number
817-447-3033
Provider Enumeration Date
05/31/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
389002 01 TX CONTRACT
000389002 01 TX CONTRACT #
116243 01 TX LICENSE
institution
Provider Business Practice Location Address Details
Address
219 Valleyglen Dr
City
Desoto
State
Texas
Zip
75115-5735
Phone Number
800-299-5161
Fax Number
817-447-3033
person
Provider Business Mailing Address Details
Address
219 Valleyglen Dr
City
Desoto
State
Texas
Zip
75115-5735
Phone Number
800-299-5161
Fax Number
817-447-3033
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
()
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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