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General NPI Number Information
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NPI Number | 1972708832
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Entity Type | Organization
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Legal Business Name | BROADSTEP-WISCONSIN, INC.
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 06/16/2021
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Provider Practice Location Address
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Address Line | 1205 S 70TH ST STE 101
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City | WEST ALLIS
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State | WI
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Zip | 53214-3167
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Country | US
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Telephone | 414-871-6122
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Fax | 414-871-2522
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Provider Business Mailing Address
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Address Line | 1205 S 70TH ST STE 101
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City | WEST ALLIS
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State | WI
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Zip | 53214-3167
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Country | US
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Telephone | 414-871-6122
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Fax | 414-871-2522
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT
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Name | JULIANNE YOPPS
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Credential |
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Telephone | 414-930-4421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 1093
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License Number State | WI
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