Organization
BROADSTEP-WISCONSIN, INC.
Active
Other names
Stoneridge-Watertown
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANNE YOPPS (EXECUTIVE ASSISTANT)
(414) 930-4421
Entity
Organization
Contact information
Practice address
1421 STONERIDGE DR, WATERTOWN, WI 53098-3419
(920) 390-2900
(920) 390-2951
Mailing address
1205 S 70TH ST STE 202, WEST ALLIS, WI 53214-3167
(414) 930-4421
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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