BROADSTEP ACADEMY-ILLINOIS INC – NPI #1093919797
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

BROADSTEP ACADEMY-ILLINOIS INC is a community based residential treatment facility located in FREEPORT, IL. NPPES has assigned the NPI number 1093919797 to BROADSTEP ACADEMY-ILLINOIS INC on June 14, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

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
1093919797
Enumeration Date

(about 19 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
239 WINNEFRED ST.
FREEPORT, IL 61032
Phone: (815) 235-8071 Fax:
Mailing address
701 W LAMM RD
FREEPORT, IL 61032-9630
Phone: (815) 233-6162 Fax: (815) 233-6167
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
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)		 IL 03C004

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.