NPI 1104494921

Broadstep-Wisconsin, INC.

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Watertown, WI

Practice location

Address: 101 Eichstaedt Ln, Watertown, WI 53094-6201
Phone: (920) 390-4550
Fax: (920) 390-4551
Mailing address: 1205 S 70th St STE 202, West Allis, WI 53214-3167

Authorised official

Name: Julianne Yopps
Title: Executive Assistant
Phone: (414) 930-4421

Registered specialties (3)

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Assisted Living Facility

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320900000X

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Registry record

NPI: 1104494921
Entity type: Organization
NPI issued: 17 Jun 2021
Record last updated: 17 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.