ROSECRANCE INC; NPI #1346656923

Contact Information

ROSECRANCE INC

2704 N MAIN ST
ROCKFORD, IL 61103

Phone: 815-391-1000
Fax: 815-316-4726
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center

Indicates primary specialty

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NPI Profile & details for ROSECRANCE INC

NPI # 1346656923

LBN Legal business name ROSECRANCE INC

Authorized official PHILIP EATON - (CEO / PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/03/2014

Last updated 09/05/2018 - About 8 years ago

Identifiers

IL	License #	40108
IL	Medicaid	04081
IL	Medicaid	A-0601-0044-A

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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