Healthcare Provider Details

I. General information

NPI: 1730003641
Provider Name (Legal Business Name): ROSECRANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 ROYAL AVE STE 208
MONONA WI
53713-1518
US

IV. Provider business mailing address

1021 N MULFORD RD
ROCKFORD IL
61107-3874
US

V. Phone/Fax

Practice location:
  • Phone: 815-391-1000
  • Fax: 815-316-4726
Mailing address:
  • Phone: 815-387-5600
  • Fax: 815-316-4726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BRITTON CARLSON
Title or Position: REVENUE CYCLE DIRECTOR
Credential:
Phone: 815-387-5664