Active NPI
Mosaic
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Liberal, KS
National Provider Identifier
1053468165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Legal business name
- MOSAIC
- Practice address
- 441 Industrial Park Ave
Liberal, KS 67901-5107 - Phone
- (620) 624-3817
- Fax
- (620) 626-4507
- NPI assigned
- Jan 4, 2007
- Last updated
- Jan 18, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Scott Hoffman
- Title
- Sr VP & Chief Financ
- Phone
- (402) 896-3884
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | KS | ||
| Developmentally Disabled Services Day Training Agency | 251C00000X | KS | ||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | NU | Primary | |
| Personal Care Attendant | 3747P1801X | KS |
Addresses
Primary practice location
441 Industrial Park Ave
Liberal, KS 67901-5107
Mailing address
4980 S 118TH St
Omaha, NE 68137-2200
Phone (402) 896-3884
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100008340A | Other | KS | TCM |
| 200329400M | Other | KS | NON-EMERGENCY TRANS |
| 200329400 I | Other | KS | LIBERAL'S TCM # |
| 200329400H | Other | KS | RESIDENTIAL, VOCATIONAL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | OTHER | Other |
National Provider Directory
National Provider Directory- Tax ID family
- Mosaic
Organizations with this tax ID in the same state 5
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Developmentally Disabled Services Day Training Agency
- Ellsworth, KS
- NPI 1366594368
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Pittsburg, KS
- NPI 1477863488
-
- Personal Care Attendant
- Garden City, KS
- NPI 1639226640
-
- Developmentally Disabled Services Day Training Agency
- Winfield, KS
- NPI 1669524666
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Leawood, KS
- NPI 1851448872
Locations
441 Industrial Park Ave
Liberal, KS 67901
Phone (620) 624-3817
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705536000000",
"number": "1053468165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4980 S 118TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681372200",
"telephone_number": "402-896-3884",
"fax_number": "402-894-4780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "441 INDUSTRIAL PARK AVE",
"city": "LIBERAL",
"state": "KS",
"postal_code": "679015107",
"telephone_number": "620-624-3817",
"fax_number": "620-626-4507"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOSAIC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-04",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A",
"authorized_official_last_name": "HOFFMAN",
"authorized_official_first_name": "SCOTT",
"authorized_official_title_or_position": "SR VP & CHIEF FINANC",
"authorized_official_telephone_number": "402-896-3884",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "KS",
"license": null,
"primary": false
},
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "KS",
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "KS",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TCM",
"identifier": "100008340A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NON-EMERGENCY TRANS",
"identifier": "200329400M",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIBERAL'S TCM #",
"identifier": "200329400 I",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RESIDENTIAL, VOCATIONAL",
"identifier": "200329400H",
"state": "KS"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "OTHER",
"affiliation": "N",
"endpointDescription": "OTHER",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "OTHER",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "441 N Industrial Ave",
"city": "Liberal",
"state": "KS",
"country_code": "US",
"postal_code": "679051871",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Liberal, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.