Mosaic

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Des Moines, IA

NPI 1053463992 · NPPES record last updated Jan 22, 2024

Key facts

NPI
1053463992
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
770674 (IA)
Legal business name
MOSAIC
Practice address
1609 Cummins Parkway
Des Moines, IA 50311-0000
Phone
(515) 246-1840
Fax
(515) 246-8236
NPI assigned
Jan 18, 2007
Organization subpart
No

Authorized official

Name
Scott Hoffman
Title
Senior VP & Chief Financial Officer
Phone
(402) 896-3884

Corporate family (same tax ID) 12

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Mosaic (99 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 770674 IA Yes

Addresses

Primary practice location

1609 Cummins Parkway
Des Moines, IA 50311-0000

Mailing address

4980 S 118TH St
Omaha, NE 68137-2220
Phone (402) 896-3884

Other identifiers

IdentifierTypeStateIssuer
0881953MedicaidIA

Other providers in Des Moines, IA

All providers in Des Moines, IA · Intellectual Disabilities Intermediate Care Facility in Iowa

Sources for this page

Verify at the official NPI Registry.