Mosaic

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

780204 Issued in IA

Legal business name

MOSAIC

Practice address

217 E 7TH St
Logan, IA 51546-1348

Phone

(712) 644-2378

Fax

(712) 664-3501

NPI assigned

Jan 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dean Wilson

Title

VP Accounting

Phone

(402) 896-3884

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Mosaic99 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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
  • Des Moines, IA
  • NPI 1326190265
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Des Moines, IA
  • NPI 1336291277
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Des Moines, IA
  • NPI 1336882968
  NPD tax ID
• Mosaic

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Forest City, IA
  • NPI 1366718298
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Des Moines, IA
  • NPI 1417009358
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • West Des Moines, IA
  • NPI 1427100361
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Des Moines, IA
  • NPI 1447302385
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Forest City, IA
  • NPI 1487920351
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Des Moines, IA
  • NPI 1508918442
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Des Moines, IA
  • NPI 1528110467
  NPD tax ID
• Mosaic

  • Intellectual Disabilities Intermediate Care Facility
  • Des Moines, IA
  • NPI 1538211479
  NPD tax ID
• Mosaic

  • Mental Illness Community Based Residential Treatment Facility
  • Denison, IA
  • NPI 1558402271
  NPD tax ID

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568514487",
    "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": "681372220",
            "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": "217 E 7TH ST",
            "city": "LOGAN",
            "state": "IA",
            "postal_code": "515461348",
            "telephone_number": "712-644-2378",
            "fax_number": "712-664-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "VP ACCOUNTING",
        "authorized_official_telephone_number": "402-896-3884"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "IA",
            "license": "780204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0896779",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Ann Logan-Brummer, MA. LMHC,CADC
• Brittany Michelle Long
• Haleigh Anne Mann
• Mosaic
• Mosaic
• Mosaic
• Mosaic
• Natalie Ruth Peterson, MS CCC SLP
• Dustin M Rockwell, PTA
• Sanctuary Recovery Ministries PC

• Adult Care Home Facility in Logan, IA
• Providers in Logan, IA by specialty
• Adult Care Home Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.