Organization
BROADSTEP-WISCONSIN, INC.
Active
Other names
CSP North
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANNE YOPPS (EXECUTIVE ASSISTANT)
(414) 930-4421
Entity
Organization
Contact information
Practice address
1205 S 70TH ST STE 101, WEST ALLIS, WI 53214-3167
(414) 871-6122
(414) 871-2522
Mailing address
1205 S 70TH ST STE 101, WEST ALLIS, WI 53214-3167
(414) 871-6122
(414) 871-2522
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
1093
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093
STATE CERTIFICATE-LICENSE
WI
05
—
43422300
—
WI
Enumeration date
06/19/2007
Last updated
06/16/2021
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