BRAVO CARE OF ROCKFORD INC NPI 1003003765

Skilled Nursing Facility in Rockford, IL

About BRAVO CARE OF ROCKFORD INC

Bravo Care Of Rockford Inc is a provider in Rockford, IL. The NPI number assigned to this provider is 1003003765. The practitioner's primary taxonomy code is Skilled Nursing Facility (314000000X). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Rosewood Care Center Of Rockford.

NPI1003003765 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameBRAVO CARE OF ROCKFORD INC
Provider Location Address1660 S MULFORD RD ROCKFORD, IL 61108 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address11701 BORMAN DR STE 315 SAINT LOUIS, MO 63146 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NameROSEWOOD CARE CENTER OF ROCKFORD Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeDoing Business As (3)
Enumeration Date09-26-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date12-01-2016 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

BRAVO CARE OF ROCKFORD INC
1660 S MULFORD RD
ROCKFORD, IL
ZIP 61108
Phone: (815) 397-8700
Get Directions

Mailing Address

BRAVO CARE OF ROCKFORD INC
11701 BORMAN DR STE 315
SAINT LOUIS, MO
ZIP 63146
Phone:

Primary Taxonomy

Taxonomy Code314000000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationSkilled Nursing Facility
TypeNursing & Custodial Care Facilities
License No.1854120
License StateIL
Taxonomy Description(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Authorized Official

Authorized Official Name ALEKSANDRA SAVIC Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleAR DIRECTOR
Authorized Official Phone(314) 994-9070

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral NutritionILNo

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
6102310001MEDICARE NSC (07)IL
=========001MEDICAID (05)IL
145891MEDICARE OSCAR/CERTIFICATION (06)IL

Map Location


BRAVO CARE OF ROCKFORD INC address is 1660 S MULFORD RD ROCKFORD, IL 61108

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1306841135ROSEWOOD CARE CENTER, INC OF ROCKFORD
Organization
Skilled Nursing Facility1660 S MULFORD RD
ROCKFORD, IL 61108
(815) 397-8700
1700329240ROCKFORD NH LLC
Organization
Skilled Nursing Facility1660 S MULFORD RD
ROCKFORD, IL 61108
(815) 397-8700