NPIMap

Organization Active NPI

Mosaic Community Services, Inc.

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baltimore, MD
National Provider Identifier
1588016422
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
License
MH-2044 Issued in MD
Legal business name
MOSAIC COMMUNITY SERVICES, INC.
Practice address
234 S Broadway
Baltimore, MD 21231-2405
Phone
(410) 675-4704
NPI assigned
Jul 3, 2016
Last updated
Jul 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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

Authorized official

Name
Jeff Richardson, CEO
Title
Chief Executive Officer
Phone
(410) 453-9553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X MH-2044 MD Primary

Addresses

Primary practice location

234 S Broadway
Baltimore, MD 21231-2405

Mailing address

1925 Greenspring Dr
Timonium, MD 21093-4128
Phone (410) 453-9553

Other identifiers 1

IdentifierTypeStateIssuer
MH-2044OtherMDDHMH LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Mosaic Community Services Inc47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1467504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1588016422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 GREENSPRING DR",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210934128",
            "telephone_number": "410-453-9553",
            "fax_number": "443-612-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 S BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212312405",
            "telephone_number": "410-675-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-03",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "410-453-9553",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "MD",
            "license": "MH-2044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHMH LICENSE",
            "identifier": "MH-2044",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.