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Organization

MOSAIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT HOFFMAN (SVP CHIEF FINANCIAL OFFICER)
(402) 896-3884
Entity
Organization

Contact information

Practice address
2901 PROFESSIONAL LN, TERRE HAUTE, IN 47802-3300
(812) 235-3399
(812) 235-1590
Mailing address
4980 S 118TH ST, OMAHA, NE 68137-2220
(402) 896-3884
(402) 894-4780

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200819770B
IN
Enumeration date
02/07/2007
Last updated
05/21/2025
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