Mosaic

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

NPI 1831246552 · NPPES record last updated Jun 11, 2020

Key facts

NPI
1831246552
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
430775 (IA)
Legal business name
MOSAIC
Practice address
309 East Second Street
Logan, IA 52546
Phone
(712) 644-2378
Fax
(712) 664-3501
NPI assigned
Jan 4, 2007
Organization subpart
No

Authorized official

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

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)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 430775 IA Yes

Addresses

Primary practice location

309 East Second Street
Logan, IA 52546

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
0882027MedicaidIA

Other providers in Logan, IA

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

Sources for this page

Verify at the official NPI Registry.