Organization
ROSECRANCE INC
Active
Other names
Rosecrance Woodstock House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP EATON MBA (CEO / PRESIDENT)
(815) 391-1000
Entity
Organization
Contact information
Practice address
876 PLEASANT ST, WOODSTOCK, IL 60098-2245
(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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A-0601-0039-A
—
IL
Enumeration date
08/28/2014
Last updated
04/26/2018
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