National Provider Identifier Database

ROSECRANCE INC
Mental Health (Including Community Mental Health Center)


Contact Information

ROSECRANCE INC
2704 N MAIN ST
ROCKFORD, IL61103
Phone: 815-391-1000
Fax: 815-316-4726
Website:
Specialty Taxonomy Code
* Mental Health (Including Community Mental Health Center) 261QM0801X

* Indicates primary specialty

NPI Profile & details for ROSECRANCE INC

NPI Number 1346656923
Legal business name
LBN
ROSECRANCE INC
Authorized official PHILIP EATON - (CEO / PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 07/03/2014
Last updated 09/05/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • IL License #: 40108
  • IL Medicaid: 04081
  • IL Medicaid: A-0601-0044-A

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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