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Organization
MOSAIC COMMUNITY SERVICES
Active
Organization
MOSAIC COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY W RICHARDSON LCSW-C (CHIEF EXECUTIVE OFFICER)
(410) 453-9553
Entity
Organization
Contact information
Practice address
27 MELLOR AVE, CATONSVILLE, MD 21228-5106
(443) 612-1497
(443) 830-1521
Mailing address
1925 GREENSPRING DR, TIMONIUM, MD 21093-4128
(410) 453-9553
(443) 612-1488
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159830305
—
MD
Enumeration date
02/06/2008
Last updated
05/01/2015
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