Organization
ROSECRANCE INC
Active
Organization
ROSECRANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHIL EATON (PRESIDENT CEO)
(815) 391-1000
Entity
Organization
Contact information
Practice address
N27W23957 PAUL RD, SUITE 101, PEWAUKEE, WI 53072-6223
(815) 391-1000
(815) 316-4726
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2012
Last updated
10/12/2012
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