Crusaders Central Clinic Association

NPI #1164999892 in Rockford, Illinois

Provider Information

NPI Number: 1164999892
Entity Type: Organization
Organization Name: Crusaders Central Clinic Association
Subpart: Yes (part of a larger organization)
Parent Organization: CRUSADERS CENTRAL CLINIC ASSOCIATION
Primary Specialty: Case Management
Enumeration Date: Oct 31, 2018
Last Updated: Feb 25, 2022

Practice Location

Address: 1200 W STATE ST
City: Rockford
State: Illinois
ZIP Code: 61102-2112
Phone: (815) 490-1600

Authorized Official

Name: SAMUEL MILLER
Title: PRESIDENT & CEO
Phone: (815) 490-1737

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X	Primary

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