Organization
BROADSTEP ACADEMY-ILLINOIS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEDRIAN COLEMAN (DIRECTOR REVENUE CYCLE)
(919) 709-0197
Entity
Organization
Contact information
Practice address
833 S 16TH AVE, FREEPORT, IL 61032-5921
(815) 232-1616
Mailing address
701 W LAMM RD, FREEPORT, IL 61032-9630
(815) 233-6162
(815) 233-6167
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
036004
IL
Other
Enumeration date
06/13/2007
Last updated
08/25/2021
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