Broadstep Academy-Illinois INC

NPI #1114223245 in Freeport, Illinois

Provider Information

NPI Number: 1114223245
Entity Type: Organization
Organization Name: Broadstep Academy-Illinois INC
Subpart: Yes (part of a larger organization)
Parent Organization: PHOENIX CARE SYSTEMS, INC.
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 8, 2011
Last Updated: Aug 25, 2021

Practice Location

Address: 701 W LAMM RD
City: Freeport
State: Illinois
ZIP Code: 61032-9630
Phone: (815) 233-6162

Authorized Official

Name: KEDRIAN COLEMAN
Title: DIRECTOR REVENUE CYCLE
Phone: (919) 709-0197

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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Broadstep Academy-Illinois INC	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	Freeport	AI Deep Dive

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