Organization
BROADSTEP-WISCONSIN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARL RAJANI (CEO)
(414) 301-6381
Entity
Organization
Contact information
Practice address
3959 S 51ST ST, MILWAUKEE, WI 53220-2653
(414) 321-9447
Mailing address
217 WISCONSIN AVE STE 204, WAUKESHA, WI 53186-4946
(414) 301-6384
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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