Organization
ROSECRANCE, INC.
Active
Organization
ROSECRANCE, INC.
Active
Other names
Rosecrance Berry Campus
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP EATON (CEO/PRESIDENT)
(815) 391-1000
Entity
Organization
Contact information
Practice address
8616 NORTHERN AVE, ROCKFORD, IL 61107-5309
(815) 391-1000
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
(815) 387-5600
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
A-0601-0037-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A-0601-0037-A
—
IL
Enumeration date
02/09/2016
Last updated
02/09/2016
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