Mosaic

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Denison, IA

NPI 1730231663 · NPPES record last updated Nov 6, 2020

Key facts

NPI
1730231663
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
240787 (IA)
Legal business name
MOSAIC
Practice address
1200 S 15TH St
Denison, IA 51442-2800
Phone
(712) 644-2378
Fax
(712) 664-3501
NPI assigned
Jan 18, 2007
Organization subpart
No

Authorized official

Name
Jeri Sole
Title
Director of Billing
Phone
(402) 896-5827

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Mosaic (99 organizations share this tax ID)

Locations

1200 S 15th St
Denison, IA 51442
Phone (712) 644-2378

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 240787 IA Yes

Addresses

Primary practice location

1200 S 15TH St
Denison, IA 51442-2800

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
0882001MedicaidIA

Other providers in Denison, IA

All providers in Denison, IA · Intellectual Disabilities Intermediate Care Facility in Iowa

Sources for this page

Verify at the official NPI Registry.