Healthcare Provider Details

I. General information

NPI: 1114834207
Provider Name (Legal Business Name): BROADSCOPE DISABILITY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6102 W LAYTON AVE
GREENFIELD WI
53220-4608
US

IV. Provider business mailing address

6102 W LAYTON AVE
GREENFIELD WI
53220-4608
US

V. Phone/Fax

Practice location:
  • Phone: 414-329-4505
  • Fax:
Mailing address:
  • Phone: 414-329-4505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MARY SCHINKOWITCH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 414-329-4505