Organization
ROSECRANCE INC
Active
Other names
Rosecrance - 3C
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHIL W EATON MS (CEO)
(815) 391-1000
Entity
Organization
Contact information
Practice address
3815 HARRISON AVE, ROCKFORD, IL 61108-7631
(815) 391-1000
(815) 316-4726
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
(815) 391-1000
(815) 316-4726
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
A-0601-0028-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A-0601-0028-A
—
IL
Enumeration date
01/28/2011
Last updated
01/08/2016
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