Organization
WILLOWGLEN ACADEMY IL
Active
Other names
Broadstep Academy-Illinois Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KEDRIAN COLEMAN (DIRECTOR REVENUE CYCLE)
(919) 709-0197
Entity
Organization
Contact information
Practice address
1606 MAGNOLIA DR # 8, CHATHAM, IL 62629-1596
(217) 697-8463
Mailing address
8521 SIX FORKS RD STE 300, RALEIGH, NC 27615-5294
(919) 709-0197
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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