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
1925 GREENSPRING DR, TIMONIUM, MD 21093-4128
(410) 453-9553
(410) 308-8926
Mailing address
1925 GREENSPRING DR, TIMONIUM, MD 21093-4128
(410) 453-9553
(410) 308-8926
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371331800
—
MD
Enumeration date
01/29/2008
Last updated
11/19/2009
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