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General NPI Number Information
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NPI Number | 1982182671
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Entity Type | Organization
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Legal Business Name | ROSECRANCE, INC.
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Dates
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Enumeration Date | 08/03/2018
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Last Update Date | 08/03/2018
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Provider Practice Location Address
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Address Line | 2835 N SHEFFIELD AVE STE 209
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City | CHICAGO
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State | IL
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Zip | 60657-5083
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Country | US
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Telephone | 815-387-5600
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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 | 61107-3877
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGED CARE CONTRACTING ASSISTANT
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Name | RACHEL SHEETS
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Credential |
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Telephone | 815-387-5680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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