Mosaic
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · West Des Moines, IA
NPI 1063564904 · NPPES record last updated Jun 11, 2020
Key facts
- NPI
- 1063564904
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- License
- 770095 (IA)
- Legal business name
- MOSAIC
- Practice address
- 2009 Prospect Avenue
West Des Moines, IA 50265-0000 - 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) 13
National Provider Directory
- Tax ID family
- Mosaic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 770095 | IA | Yes |
Addresses
Primary practice location
2009 Prospect Avenue
West Des Moines, IA 50265-0000
Mailing address
4980 S 118TH St
Omaha, NE 68137-2220
Phone (402) 896-3884
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0881862 | Medicaid | IA |
Other providers in West Des Moines, IA
- Jack L Morlan
- Alicia Juliet Morris
- Andie Morrissey
- Mollie Margaret Mortenson
- Tamara Albright Mortenson
- Mosaic
- Derek Moulds
- Moving Mountains Developmental Disability Services, LLC
- Alexis Mowrey
- Charlotte Ann Mueller
All providers in West Des Moines, IA · Intellectual Disabilities Intermediate Care Facility in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.