Organization
MOSAIC COMMUNITY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF RICHARDSON LCSW-C (CEO)
(410) 453-9553
Entity
Organization
Contact information
Practice address
1931 GREENSPRING DR, TIMONIUM, MD 21093-4113
(410) 453-9550
(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
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159380301
—
MD
05
—
159380302
—
MD
05
—
159380304
—
MD
05
—
371331800
—
MD
05
—
371331802
—
MD
05
—
404682000
—
MD
Enumeration date
01/11/2007
Last updated
09/23/2008
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