Organization
MOSAIC
Active
Organization
MOSAIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI POWELL (INTERNAL AUDIT DIRECTOR)
(402) 698-9812
Entity
Organization
Contact information
Practice address
13919 S PLZ, OMAHA, NE 68137-2916
(402) 896-9988
(402) 896-6111
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
—
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDD185
—
NE
05
—
CDD186
—
NE
05
—
CDD187
—
NE
Enumeration date
09/20/2007
Last updated
06/11/2025
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