Crusaders Central Clinic Association
Case Management in Rockford, IL. Organization (NPI-2).
NPI number1164999892
StatusActive
Last updated in NPPESFeb 25, 2022
Details
- NPI
- 1164999892
- Entity type
- Organization (NPI-2)
- Legal business name
- Crusaders Central Clinic Association
- Organization subpart
- Yes
- Enumeration date
- Oct 31, 2018
- Certification date
- Feb 25, 2022
- Last updated
- Feb 25, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251B00000X | Case Management | – | – | Yes |
Other names
- Crusader Community Health (Doing Business As)
Practice location
1200 W State StRockford, IL 61102-2112
Phone 815-490-1600
Mailing address
1200 W State StRockford, IL 61102-2112
Phone 815-490-1600 · Fax 815-490-1845
Authorized official
Samuel Miller
President & Ceo
8154901737
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