Organization Active NPI

Mosaic

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Denison, IA
National Provider Identifier
1649322579
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
MOSAIC
Practice address
1402 Settlers LN
Denison, IA 51442-1132
Phone
(712) 644-2234
Fax
(712) 644-3501
NPI assigned
Jan 18, 2007
Last updated
Dec 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Authorized official

Name
Scott Hoffman
Title
Chief Financial Officer
Phone
(402) 896-3884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X IA Primary

Addresses

Primary practice location

1402 Settlers LN
Denison, IA 51442-1132

Mailing address

4980 S 118TH St
Omaha, NE 68137-2220
Phone (402) 896-3884

Other identifiers 1

IdentifierTypeStateIssuer
0439919MedicaidIA

National Provider Directory

National Provider Directory
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.

View all 24

Locations

715 N 2nd Ave
Logan, IA 51546
Phone (712) 644-2778

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1649322579",
    "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": "1402 SETTLERS LN",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "514421132",
            "telephone_number": "712-644-2234",
            "fax_number": "712-644-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "402-896-3884"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0439919",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.

Verify at the official NPI Registry.