Broadstep Academy-Illinois Inc in Freeport - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Broadstep Academy-Illinois Inc - NPI 1093919797
Broadstep Academy-Illinois Inc is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Freeport, Illinois. Broadstep Academy-Illinois Inc practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Broadstep Academy-Illinois Inc is 1093919797. The last update date is 2021-08-25.
Broadstep Academy-Illinois Inc's current location address is 239 Winnefred St., Freeport, Illinois. You can contact this provider via phone number 8152358071. The mailing address for Broadstep Academy-Illinois Inc is 239 Winnefred St., Freeport, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Broadstep Academy-Illinois Inc |
|---|---|
| Address | 239 Winnefred St., Freeport, Illinois |
| Phone Number | 8152358071 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR R |
|---|---|
| Authorized Official Name | Coleman Kedrian |
| Telephone Number | 9197090197 |
NPI Number Detail
| NPI Number | 1093919797 |
|---|---|
| Provider Enumeration Date | 2007-06-14 |
| Last Updated Date | 2021-08-25 |
Provider Mailing Address Detail
| Address | 239 Winnefred St. |
|---|---|
| City | Freeport |
| State | Illinois (IL) |
| Post Code | 61032 |
| Phone Number | 8152358071 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320900000X |
| Licence No | 03C004 |
|
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
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What is the unique 10-digit identification code assigned to Broadstep Academy-Illinois Inc by the Centers for Medicare & Medicaid Services?
The Broadstep Academy-Illinois Inc has been issued the NPI (National Provider Identifier) 1093919797, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Broadstep Academy-Illinois Inc's physical address?
The Broadstep Academy-Illinois Inc is physically located at 239 Winnefred St., in the city of Freeport, IL, with the postal code 61032.
What is Broadstep Academy-Illinois Inc's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Broadstep Academy-Illinois Inc is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the taxonomy classification code that categorizes this area of expertise is 320900000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1093919797 to Broadstep Academy-Illinois Inc?
The Centers for Medicare & Medicaid Services assigned the 1093919797 to Broadstep Academy-Illinois Inc on 2007-06-14.
When was the Broadstep Academy-Illinois Inc's information last updated?
The Broadstep Academy-Illinois Inc's information was last updated on 2021-08-25.