Organization
BROADSTEP-WISCONSIN, INC.
Active
Other names
Manitoba Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANNE YOPPS (EXECUTIVE ASSISTANT)
(414) 930-4421
Entity
Organization
Contact information
Practice address
3018 S 9TH ST, MILWAUKEE, WI 53215-3944
(414) 483-0156
(414) 747-4760
Mailing address
3018 S 9TH ST, MILWAUKEE, WI 53215-3944
(414) 483-0156
(414) 747-4760
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
1004077
WI
Other
Enumeration date
07/03/2007
Last updated
04/28/2021
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