Organization
ROSECRANCE, INC.
Active
Organization
ROSECRANCE, INC.
Active
Other names
Rosecrance Greendale House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP W. EATON MASTERS IN SCIENCE (PRESIDENT/CEO)
(815) 391-1000
Entity
Organization
Contact information
Practice address
3522 GREEN DALE DR, ROCKFORD, IL 61109-1575
(815) 391-5095
(815) 484-4750
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
(815) 391-1000
(815) 391-5040
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
A-0601-0002-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A-0601-0002-A
—
IL
Enumeration date
02/26/2008
Last updated
11/25/2015
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