NPIMap

Organization Active NPI

Broadstep-Wisconsin, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Watertown, WI
National Provider Identifier
1912575796
Registry record updated Jun 16, 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
304 E Haven Dr
Watertown, WI 53094-7321
Phone
(920) 390-4488
Fax
(920) 390-4489
NPI assigned
Jun 16, 2021
Last updated
Jun 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

304 E Haven Dr
Watertown, WI 53094-7321

Mailing address

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

Other names 1

  • East Haven I 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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1912575796",
    "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": "304 E HAVEN DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530947321",
            "telephone_number": "920-390-4488",
            "fax_number": "920-390-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADSTEP-WISCONSIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "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": "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": "East Haven I",
            "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 16, 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.