ROSECRANCE INC NPI 1285040865

NPI Information

NPI: 1285040865
Provider Name: ROSECRANCE INC

Doing Business As: ROSECRANCE MULBERRY

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
605 MULBERRY ST
ROCKFORD, IL
ZIP 61103
Phone: (815) 391-1000
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ROSECRANCE INC is a mental health (including community mental health center) clinic center in Rockford, IL. ROSECRANCE INC NPI is 1285040865. The provider is registered as an organization entity type.
The provider Is Doing Business As Rosecrance Mulberry.

The provider's business location address is:

605 MULBERRY ST
ROCKFORD, IL
ZIP 61103-746
Phone: (815) 391-1000
Fax: (815) 316-4726

The provider's authorized official is Philip Eaton .
The authorized official title is Ceo / President and has the following contact phone number (815) 391-1000.

The enumeration date for this NPI number is 7/3/2014 and was last updated on 12/4/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				No
2	324500000X	Substance Abuse Rehabilitation Facility				No
3	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	40108	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	04081	MEDICAID	ILLINOIS
2	IL8148	MEDICARE UPIN	ILLINOIS
3	A-0601-0043-A	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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