Organization
MOSAIC COMMUNITY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY RICHARDSON (VP & COO COMMUNITY SERVICES)
(410) 453-9553
Entity
Organization
Contact information
Practice address
27 MELLOR AVE, CATONSVILLE, MD 21228-5106
(410) 453-9553
(443) 612-1488
Mailing address
849 FAIRMOUNT AVE FL 5, TOWSON, MD 21286-2624
(410) 382-8111
(443) 612-1488
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191209364
MD STATE LICENSE
MD
Enumeration date
12/03/2021
Last updated
12/14/2021
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