| NPI | 1710268008 |
|---|---|
| Doing Business As | ROSECRANCE BENTON SUPERVISED LIVING |
| Entity Type | Organization |
| Authorized Contact | PHILLIP EATON CEO / President 815-391-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: IL 04081) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2015-12-08 |