OrganizationActive
Broadstep Academy-Illinois Inc
NPI 1093919797 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Freeport, IL
Provider details
- NPI number
- 1093919797
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Kedrian Coleman, Director Revenue Cycle(919) 709-0197
- License
- 03C004 (IL)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 03C004 (IL)
Residential Treatment Facilities
Practice location
239 Winnefred St.
Freeport, IL 61032
Phone: (815) 235-8071
Approximate (ZIP-level) locationGet directions
Mailing address
701 W Lamm Rd
Freeport, IL 61032-9630
Registry dates
- Enumerated
- 2007-06-14
- Last updated
- 2021-08-25
- Certified
- 2021-08-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.