Organization
CRUSADERS CENTRAL CLINIC ASSOCIATION
Active
Parent organization
CRUSADERS CENTRAL CLINIC ASSOCIATION
Other names
Rosecrance Ware Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRUSADERS CENTRAL CLINIC ASSOCIATION
Authorized official
MR. SAMUEL MILLER (CEO/PRESIDENT)
(815) 490-1737
Entity
Organization
Contact information
Practice address
2704 N MAIN ST, ROCKFORD, IL 61103-3112
(815) 490-1600
(815) 490-1845
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1845
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
IL
Other
Enumeration date
09/13/2012
Last updated
08/08/2023
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