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Broadstep Academy-Illinois Inc

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Freeport, IL

NPI 1982808895 · NPPES record last updated Aug 25, 2021

Key facts

NPI
1982808895
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
036004 (IL)
Legal business name
BROADSTEP ACADEMY-ILLINOIS INC
Practice address
833 S 16TH Ave
Freeport, IL 61032-5921
Phone
(815) 232-1616
NPI assigned
Jun 13, 2007
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

National Provider Directory

Tax ID family
Broadstep Academy-Illinois Inc (39 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 036004 IL Yes

Addresses

Primary practice location

833 S 16TH Ave
Freeport, IL 61032-5921

Mailing address

701 W Lamm Rd
Freeport, IL 61032-9630
Phone (815) 233-6162

Other providers in Freeport, IL

All providers in Freeport, IL · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

Sources for this page

Verify at the official NPI Registry.