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General NPI Number Information
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NPI Number | 1043185432
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Entity Type | Organization
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Legal Business Name | ROSCRANCE INC.
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 939 GALENA SQUARE DR STE B
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City | GALENA
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State | IL
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Zip | 61036-1355
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Country | US
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Telephone | 815-391-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 N MULFORD RD
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City | ROCKFORD
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State | IL
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Zip | 61107-3874
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Country | US
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Telephone | 815-387-5623
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Fax | 815-387-5623
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Authorized Official
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Title or Position | DIR, REVENUE CYCLE
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Name | BRITTON CARLSON
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Credential |
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Telephone | 815-387-5664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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