# BROADSTEP-WISCONSIN, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fairfield
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073189007
- **Authorized official:** JULIANNE YOPPS (EXECUTIVE ASSISTANT)
- **Authorized official phone:** (414) 930-4421

## Contact information

- **Practice address:** 1408 FAIRFIELD CT, WATERTOWN, WI 53098-3418
- **Practice address phone:** (920) 206-1192
- **Practice address fax:** (920) 206-1409
- **Mailing address:** 1205 S 70TH ST STE 202, WEST ALLIS, WI 53214-3167
- **Mailing address phone:** (414) 930-4421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 06/01/2021
- **Last updated:** 06/01/2021