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Organization

ROSECRANCE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PHILIP W. EATON MASTER OF SCIENCE (PRESIDENT/CEO)
(815) 391-0100
Entity
Organization

Contact information

Practice address
215 N. COURT STREET, METHODIST CHURCH, ROCKFORD, IL 61103-6802
(815) 391-1000
(815) 391-5040
Mailing address
1601 N UNIVERSITY DR, ROCKFORD, IL 61107-5317
(815) 391-1000
(815) 394-5041

Taxonomy

Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
A-0601-0026-A
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
A-0601-0026-A
IL
Enumeration date
06/25/2009
Last updated
06/25/2009
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