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Organization

ROSECRANCE INC

Active
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Organization

ROSECRANCE INC

Active
Other names
Rosecrance RIC
Organization subpart
No

Provider details

NPI number
Authorized official
PHILLIP EATON (CEO / PRESIDENT)
(815) 391-1000
Entity
Organization

Contact information

Practice address
526 W STATE ST, ROCKFORD, IL 61101-1214
(815) 516-2600
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
(815) 391-1000

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
04081
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04081
—
IL
Enumeration date
08/31/2011
Last updated
05/02/2018
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