Organization
ROSECRANCE NEW LIFE OUTPATIENT CENTER
Active
Parent organization
ROSECRANCE HEALTH NETWORK
Other names
New Outpatient Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROSECRANCE HEALTH NETWORK
Authorized official
JOHN SCHUSTER (SENIOR VICE PRESIDENT/CFO)
(815) 387-5642
Entity
Organization
Contact information
Practice address
2322 E KIMBERLY RD STE 200 PAUL REVERE SQ, DAVENPORT, IA 52807-3042
(563) 355-0055
(563) 355-0101
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)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1231
IA
Other
Enumeration date
11/07/2006
Last updated
01/23/2020
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