Organization
ROSECRANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL EATON (CEO)
(815) 387-5610
Entity
Organization
Contact information
Practice address
2302 MORELAND BLVD, CHAMPAIGN, IL 61822-1398
(815) 387-5600
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04081
—
IL
Enumeration date
12/20/2018
Last updated
12/20/2018
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