Mosaic

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

MOSAIC

Practice address

2000 W Park Ave
Norfolk, NE 68701-4701

Phone

(402) 379-3888

NPI assigned

Mar 2, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Scott Hoffman

Title

SVP Chief Financial Officer

Phone

(402) 896-3884

Specialties & licenses 1

Addresses

Other names 1

• Mosaic in Norfolk - Park Ave ICF Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 28G110

Legal name

MOSAIC NORTHEAST AGENCY - WEST PARK AVENUE

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Feb 10, 2012

Last certification

Jun 12, 2025

Beds

6

Ownership / control type

Private (non-profit)

Facility address

2000 West Park Avenue
Norfolk, NE 68701

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Mosaic99 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Omaha, NE
  • NPI 1073831996
  NPD tax ID
• Mosaic

  • Mental Illness Intermediate Care Facility
  • Beatrice, NE
  • NPI 1386867901
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • York, NE
  • NPI 1417275546
  NPD tax ID
• Mosaic

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Omaha, NE
  • NPI 1467648725
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Papillion, NE
  • NPI 1609194521
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Grand Island, NE
  • NPI 1720273386
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Grand Island, NE
  • NPI 1790003614
  NPD tax ID
• Mosaic

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Omaha, NE
  • NPI 1922271824
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Axtell, NE
  • NPI 1972706885
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Omaha, NE
  • NPI 1982922803
  NPD tax ID
• Mosaic Inc

  • Day Training/Habilitation Specialist
  • Gretna, NE
  • NPI 1861657249
  NPD tax ID
• Mosiac

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Axtell, NE
  • NPI 1932714813
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1487952297",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W PARK AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014701",
            "telephone_number": "402-379-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "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": "SVP CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "402-896-3884"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mosaic in Norfolk - Park Ave ICF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jacob Solomon Morrill, PA-C
• Carla Morris-Von Kampen
• Kimberly Morris
• Emily Morrow
• Dana Morter
• Kyler Mosel
• Megan Mowry
• Joan Carol Mozer, RN IBLLC
• Charlee A Mucklow
• Ava Mueller

• Intellectual Disabilities Intermediate Care Facility in Norfolk, NE
• Providers in Norfolk, NE by specialty
• Intellectual Disabilities Intermediate Care Facility in Nebraska

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.