NPI 1104593565

Broadstep Academy-Illinois INC

Organisation Mental Illness Community Based Residential Treatment Facility Marengo, IL

Practice location

Address: 805 Thornapple Ln, Marengo, IL 60152-3414
Phone: (815) 568-5323
Mailing address: 8521 Six Forks Rd STE 300, Raleigh, NC 27615-5294

Authorised official

Name: Kedrian Coleman
Title: Director Revenue Cycle
Phone: (919) 709-0197

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in Illinois →

Registry record

NPI: 1104593565
Entity type: Organization
NPI issued: 24 Aug 2021
Record last updated: 25 Aug 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.