# MOSAIC COMMUNITY SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588016422
- **Authorized official:** JEFF RICHARDSON CEO (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (410) 453-9553

## Contact information

- **Practice address:** 234 S BROADWAY, BALTIMORE, MD 21231-2405
- **Practice address phone:** (410) 675-4704
- **Mailing address:** 1925 GREENSPRING DR, TIMONIUM, MD 21093-4128
- **Mailing address phone:** (410) 453-9553
- **Mailing address fax:** (443) 612-1436

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | MH-2044 | MD | Yes |

## Other

- **Enumeration date:** 07/03/2016
- **Last updated:** 07/05/2016