NPIMap

Organization Active NPI

Mosaic Community Services, Inc.

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Catonsville, MD
National Provider Identifier
1942672944
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
License
MH-1668 Issued in MD
Legal business name
MOSAIC COMMUNITY SERVICES, INC.
Practice address
7 Bloomsbury Ave
Catonsville, MD 21228-4641
Phone
(410) 453-9553
Fax
(443) 612-1436
NPI assigned
Oct 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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

Authorized official

Name
Jeff Richardson, LCSW-C
Title
Ceo
Phone
(410) 453-9553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X MH-1668 MD Primary

Addresses

Primary practice location

7 Bloomsbury Ave
Catonsville, MD 21228-4641

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
MH-1668OtherMDDHMH 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

Locations

7 Bloomsbury Ave
Catonsville, MD 21228

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1942672944",
    "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": "7 BLOOMSBURY AVE",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284641",
            "telephone_number": "410-453-9553",
            "fax_number": "443-612-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-453-9553",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "MD",
            "license": "MH-1668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHMH LICENSE",
            "identifier": "MH-1668",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.