BROADSTEP ACADEMY-NEW JERSEY INC. NPI 1598898603

NPI Information

NPI: 1598898603
Provider Name: BROADSTEP ACADEMY-NEW JERSEY, INC.

Former Legal Business Name: WILLOWGLEN ACADEMY

Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
8 WILSON DR.
SPARTA, NJ
ZIP 07871
Phone: (973) 579-3700
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BROADSTEP ACADEMY-NEW JERSEY, INC. is a residential treatment facility, intellectual and/or developmental disabilities in Sparta, NJ. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. BROADSTEP ACADEMY-NEW JERSEY, INC. NPI is 1598898603. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Willowglen Academy.

The provider's business location address is:

8 WILSON DR.
SPARTA, NJ
ZIP 07871-491
Phone: (973) 579-3700
Fax: (973) 579-1786

The provider's authorized official is Patty Bates .
The authorized official title is Accounting Manager and has the following contact phone number (973) 579-3700.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 5/9/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children				No
2	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	8374104	MEDICAID	NEW JERSEY
2	8378304	MEDICAID	NEW JERSEY
3	8374503	MEDICAID	NEW JERSEY
4	8401403	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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