BROADSTEP ACADEMY-ILLINOIS INC – NPI #1104593565
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Mental Illness

BROADSTEP ACADEMY-ILLINOIS INC is a community based residential treatment facility located in MARENGO, IL. NPPES has assigned the NPI number 1104593565 to BROADSTEP ACADEMY-ILLINOIS INC on August 24, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

The NPI profile was previously updated about 5 years ago on Aug 25, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BROADSTEP ACADEMY-ILLINOIS INC below.

NPI Profile for
BROADSTEP ACADEMY-ILLINOIS INC

NPI Number
1104593565
Enumeration Date

(about 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BROADSTEP ACADEMY-ILLINOIS INC
Primary location
805 THORNAPPLE LN
MARENGO, IL 60152-3414
Phone: (815) 568-5323 Fax:
Mailing address
8521 SIX FORKS RD STE 300
RALEIGH, NC 27615-5294
Phone: (919) 709-0197 Fax:
Organization Subpart
No
Authorized Official
KEDRIAN COLEMAN
DIRECTOR REVENUE CYCLE
Phone: (919) 709-0197
Updated
Certification Date
Aug 25, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.