NPIMap

Organization Active NPI

Broadstep-Wisconsin, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Watertown, WI
National Provider Identifier
1104494921
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
BROADSTEP-WISCONSIN, INC.
Practice address
101 Eichstaedt LN
Watertown, WI 53094-6201
Phone
(920) 390-4550
Fax
(920) 390-4551
NPI assigned
Jun 17, 2021
Last updated
Jun 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU

Addresses

Primary practice location

101 Eichstaedt LN
Watertown, WI 53094-6201

Mailing address

1205 S 70TH St Ste 202
West Allis, WI 53214-3167
Phone (414) 930-4421

Other names 1

  • Eicksteadt Other name

National Provider Directory

National Provider Directory
Tax ID family
Bell Therapy Inc CSP South58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

101 Eichstaedt Ln
Watertown, WI 53094
Phone (920) 390-4550

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1104494921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 S 70TH ST STE 202",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532143167",
            "telephone_number": "414-930-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EICHSTAEDT LN",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946201",
            "telephone_number": "920-390-4550",
            "fax_number": "920-390-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADSTEP-WISCONSIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "YOPPS",
        "authorized_official_first_name": "JULIANNE",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "414-930-4421"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eicksteadt",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.